MEDICARE: DEBRA G MILNER RN, LCSW

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	1041C0700X	Clinical Social Worker	12287	AZ

General Provider Information

NPI Number	:	1669835179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA G MILNER RN, LCSW

Provider Business Mailing Address
First Line	:	38000 S ARIVACA RANCH RD
Second Line	:
City	:	ARIVACA
State	:	AZ
Zip	:	85601
Country	:	US
Telephone Number	:	520-345-7293
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-5802
Country	:	US
Telephone Number	:	520-331-5630
Fax Number	:

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

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	04/01/2016

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