Provider Demographics
NPI:1376786566
Name:MILLSAP, AMY B (PA-C)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:B
Last Name:MILLSAP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:639A STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5970
Mailing Address - Country:US
Mailing Address - Phone:912-354-7124
Mailing Address - Fax:912-353-8944
Practice Address - Street 1:639A STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5970
Practice Address - Country:US
Practice Address - Phone:912-354-7124
Practice Address - Fax:912-353-8944
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1863363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical