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NPI Code Detail

MEDICARE: PRINCESS MILLIGAN

MEDICARE: PRINCESS MILLIGAN
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
1343900000XNon-emergency Medical Transport (VAN)LA

General Provider Information

NPI Number : 1942896980
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRINCESS MILLIGAN
Provider Business Mailing Address
First Line : 2439 POPLAR ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-1525
Country : US
Telephone Number : 337-842-1913
Fax Number :
Provider Business Practice Location Address
First Line : 2439 POPLAR ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-1525
Country : US
Telephone Number : 337-842-1913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2020
Last Update Date : 01/12/2021

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Directions to “ PRINCESS MILLIGAN ” Practice Location

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