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NPI Code Detail

MEDICARE: MR. STUART DAVID MILAN NURSE PRACTITIONER

MEDICARE: MR. STUART DAVID MILAN NURSE PRACTITIONER
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner850823MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689766958
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STUART DAVID MILAN NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 3450 HIGHWAY 80 W
Second Line :
City : JACKSON
State : MS
Zip : 39209-7201
Country : US
Telephone Number : 601-321-2400
Fax Number : 601-985-5174
Provider Business Practice Location Address
First Line : 3450 HIGHWAY 80 W
Second Line :
City : JACKSON
State : MS
Zip : 39209-7201
Country : US
Telephone Number : 601-321-2400
Fax Number : 601-985-5174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 02/01/2019

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