| Doctor Name: | MARY LYNN MILAM |
| NPI Number: | 1013956341 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 255063 |
| Business Practice Address: | 301 40th St Lubbock, TX - 794042746 |
| Business Phone Number: | 8067439595 |
| Business Fax Number: | |
| Mailing Address: | 7722 Woodrow Rd, WOLFFORTH |
| State: | TX |
| Postal Code: | 793825613 |
| Phone Number: | 8068632853 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2006 |
| NPI Last Update Date: | 03/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LC1500X |
| License Number: | 255063 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |