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NPI Code Detail

MEDICARE: TINA MILLISON APRN, CNP

MEDICARE: TINA MILLISON APRN, CNP
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.0034004OH

General Provider Information

NPI Number : 1538843248
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MILLISON APRN, CNP
Provider Business Mailing Address
First Line : 4235 TUSCARAWAS ST W SPC C
Second Line :
City : CANTON
State : OH
Zip : 44708-5424
Country : US
Telephone Number : 234-254-7484
Fax Number :
Provider Business Practice Location Address
First Line : 4235 TUSCARAWAS ST W
Second Line :
City : CANTON
State : OH
Zip : 44708-5424
Country : US
Telephone Number : 234-203-4232
Fax Number : 330-266-4386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2023
Last Update Date : 05/19/2026

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