Provider Demographics
NPI:1538811401
Name:MILAM, ANGELA YVONNE (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:YVONNE
Last Name:MILAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PRINCESS ANNE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-7041
Mailing Address - Country:US
Mailing Address - Phone:478-952-3520
Mailing Address - Fax:
Practice Address - Street 1:111 PRINCESS ANNE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-7041
Practice Address - Country:US
Practice Address - Phone:478-952-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144540163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health