Provider Demographics
NPI:1285037390
Name:MILBURN, GENA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GENA
Middle Name:
Last Name:MILBURN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-2328
Mailing Address - Country:US
Mailing Address - Phone:785-242-2055
Mailing Address - Fax:785-242-0649
Practice Address - Street 1:134 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-2328
Practice Address - Country:US
Practice Address - Phone:785-242-2055
Practice Address - Fax:785-242-0649
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-14775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist