Provider Demographics
NPI:1093039000
Name:MILHOLEN, TAMMY COLWICK (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:COLWICK
Last Name:MILHOLEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 TENNESSEE AVE S
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-2524
Mailing Address - Country:US
Mailing Address - Phone:731-847-6396
Mailing Address - Fax:731-847-4511
Practice Address - Street 1:364 TENNESSEE AVE S
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2524
Practice Address - Country:US
Practice Address - Phone:731-847-6396
Practice Address - Fax:731-847-4511
Is Sole Proprietor?:No
Enumeration Date:2010-03-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14747363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518633Medicaid
TN4260727OtherBCBS
TNF0310057OtherAANP
TN4260727OtherBCBS