Doctor Name: | CHRISTY MOZINGO MILLICAN |
NPI Number: | 1649647694 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 5007954 |
Business Practice Address: | 311 S Mcneil St Burgaw, NC - 284255015 |
Business Phone Number: | 9102593377 |
Business Fax Number: | 9102593013 |
Mailing Address: | 311 S Mcneil St, Po Box 1299 BURGAW |
State: | NC |
Postal Code: | 284255015 |
Phone Number: | 9102593377 |
Fax Number: | 9102593013 |
NPI Enumeration Date: | 08/25/2015 |
NPI Last Update Date: | 09/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5007954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |