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NPI Code Detail

MEDICARE: BRIANNA NICOLE MILEM

MEDICARE: BRIANNA NICOLE MILEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1457782575
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA NICOLE MILEM
Provider Business Mailing Address
First Line : 4989 S 72ND EAST AVE APT C
Second Line :
City : TULSA
State : OK
Zip : 74145-6757
Country : US
Telephone Number : 602-653-6883
Fax Number :
Provider Business Practice Location Address
First Line : 4989 S 72ND EAST AVE
Second Line : APT C
City : TULSA
State : OK
Zip : 74145-6757
Country : US
Telephone Number : 602-653-6883
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2013
Last Update Date : 11/30/2013

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Directions to “ BRIANNA NICOLE MILEM ” Practice Location

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