Provider Demographics
NPI:1689444937
Name:MILLENNIAL ADVANCED PRACTICE CONSULTANTS
Entity Type:Organization
Organization Name:MILLENNIAL ADVANCED PRACTICE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWONE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-244-0508
Mailing Address - Street 1:6534 BLUE ROSE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-4117
Mailing Address - Country:US
Mailing Address - Phone:225-244-0508
Mailing Address - Fax:
Practice Address - Street 1:6534 BLUE ROSE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-4117
Practice Address - Country:US
Practice Address - Phone:225-244-0508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care