Provider Demographics
NPI:1205375144
Name:MILHON, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MILHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ALBEMARLE CT
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-2709
Mailing Address - Country:US
Mailing Address - Phone:540-303-3104
Mailing Address - Fax:
Practice Address - Street 1:102 ALBEMARLE CT
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-2709
Practice Address - Country:US
Practice Address - Phone:540-303-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001173375163W00000X
WV95655163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse