Provider Demographics
NPI:1659713287
Name:KAUFMAN, MILLICENT (PHD, RN, APRN)
Entity Type:Individual
Prefix:
First Name:MILLICENT
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:PHD, RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 INDIAN SPRINGS DR NW
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8037
Mailing Address - Country:US
Mailing Address - Phone:828-466-2462
Mailing Address - Fax:
Practice Address - Street 1:715 FAIRGROVE CHURCH RD SE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9290
Practice Address - Country:US
Practice Address - Phone:828-638-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC157806101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health