Provider Demographics
NPI:1295029239
Name:MILLIGAN, ANGELA M (BS PHARM)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 HIGHWAY D
Mailing Address - Street 2:T-1914
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3169
Mailing Address - Country:US
Mailing Address - Phone:573-348-5963
Mailing Address - Fax:573-348-5963
Practice Address - Street 1:919 HIGHWAY D
Practice Address - Street 2:T-1914
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3169
Practice Address - Country:US
Practice Address - Phone:573-348-5963
Practice Address - Fax:573-348-5963
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO045290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist