Provider Demographics
NPI:1497798490
Name:MILLIGAN, DIANNE (ARNPC RNFA)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:MILLIGAN
Suffix:
Gender:F
Credentials:ARNPC RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PETER RD
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3659
Mailing Address - Country:US
Mailing Address - Phone:609-597-4603
Mailing Address - Fax:609-597-4922
Practice Address - Street 1:1140 ROUTE 72 W
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2412
Practice Address - Country:US
Practice Address - Phone:609-978-8900
Practice Address - Fax:610-834-2862
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00009800363LA2200X
FLARNP2016122363LA2200X
NJ26NO05034800163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0046655Medicaid
NJ203802418OtherEIN
NJ203802418OtherEIN
NJP55853Medicare UPIN
NJ054778ATWMedicare ID - Type Unspecified