MEDICARE: AMANDA MILLIARD

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
1	363LF0000X	Family Nurse Practitioner	CNP221443	ME

General Provider Information

NPI Number	:	1598468589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MILLIARD

Provider Business Mailing Address
First Line	:	75 GRAY RD
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-2010
Country	:	US
Telephone Number	:	207-535-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 GRAY RD
Second Line	:
City	:	FALMOUTH
State	:	ME
Zip	:	04105-2010
Country	:	US
Telephone Number	:	207-535-1340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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Directions to “ AMANDA MILLIARD ” Practice Location

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