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NPI Code Detail

MEDICARE: ALYSSA N MILAM FNP-C

MEDICARE: ALYSSA N MILAM FNP-C
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
1163WG0000XGeneral Practice Registered Nurse0001248687VA
2363LF0000XFamily Nurse Practitioner0024176873VA

General Provider Information

NPI Number : 1972088797
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA N MILAM FNP-C
Provider Business Mailing Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number :
Provider Business Practice Location Address
First Line : 946 N MAIN ST
Second Line :
City : CHASE CITY
State : VA
Zip : 23924-1139
Country : US
Telephone Number : 434-372-5141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2018
Last Update Date : 11/26/2018

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Directions to “ ALYSSA N MILAM FNP-C” Practice Location

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