Provider Demographics
NPI:1265464580
Name:MILBY, JAMIE WALKER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:WALKER
Last Name:MILBY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 REIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-1140
Mailing Address - Country:US
Mailing Address - Phone:270-898-2767
Mailing Address - Fax:
Practice Address - Street 1:2620 PERKINS CREEK DR
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-7494
Practice Address - Country:US
Practice Address - Phone:270-444-8465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA 252363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical