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NPI Code Detail

MEDICARE: MS. GLORIA MILBOURN P.A.

MEDICARE:  MS. GLORIA  MILBOURN  P.A.
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
1363A00000XPhysician Assistant1070NE

Other Identifiers

General Provider Information

NPI Number : 1669581708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLORIA MILBOURN P.A.
Provider Business Mailing Address
First Line : PO BOX 3755
Second Line :
City : OMAHA
State : NE
Zip : 68103-0755
Country : US
Telephone Number : 402-354-2100
Fax Number : 402-354-2155
Provider Business Practice Location Address
First Line : 203 MAIN STREET
Second Line :
City : LOUISVILLE
State : NE
Zip : 68037
Country : US
Telephone Number : 402-354-9050
Fax Number : 402-234-5202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 12/20/2013

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Directions to “ MS. GLORIA MILBOURN P.A.” Practice Location

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