| Doctor Name: | ANASTASIA BROOKE MILLIRON |
| NPI Number: | 1669792859 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | NP987-A |
| Business Practice Address: | 708 E Wythe Creek Ct #103 Kuna, ID - 836342473 |
| Business Phone Number: | 2089225130 |
| Business Fax Number: | 2083752217 |
| Mailing Address: | 777 N Raymond St, BOISE |
| State: | ID |
| Postal Code: | 837049251 |
| Phone Number: | 2085142500 |
| Fax Number: | 2083752217 |
| NPI Enumeration Date: | 06/10/2010 |
| NPI Last Update Date: | 05/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP987-A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |