Provider Demographics
NPI:1043205818
Name:MILIONIS, BRYNA K (FNP-C)
Entity Type:Individual
Prefix:
First Name:BRYNA
Middle Name:K
Last Name:MILIONIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BRYNA
Other - Middle Name:K
Other - Last Name:GROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1815 W 13TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4054
Mailing Address - Country:US
Mailing Address - Phone:302-652-4705
Mailing Address - Fax:302-652-2917
Practice Address - Street 1:1815 W 13TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4054
Practice Address - Country:US
Practice Address - Phone:302-652-4705
Practice Address - Fax:302-652-2917
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE001140242Medicaid
DE00A470J40Medicare ID - Type UnspecifiedPROVIDER NUMBER
DE019593C67Medicare PIN
DEP33996Medicare UPIN