Provider Demographics
NPI:1043863939
Name:MILO, CHRISTINE ANN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANN
Last Name:MILO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:HAGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14391 CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4363
Mailing Address - Country:US
Mailing Address - Phone:561-371-2824
Mailing Address - Fax:
Practice Address - Street 1:81 NORTHSIDE DAWSON DR STE 100
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-7164
Practice Address - Country:US
Practice Address - Phone:706-216-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285034363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner