Provider Demographics
NPI:1689858334
Name:MILCHOVICH, SUELLYN KRAMER (RN,CDE)
Entity Type:Individual
Prefix:MRS
First Name:SUELLYN
Middle Name:KRAMER
Last Name:MILCHOVICH
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2943
Mailing Address - Country:US
Mailing Address - Phone:626-251-1410
Mailing Address - Fax:626-251-1558
Practice Address - Street 1:420 W ROWLAND ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2943
Practice Address - Country:US
Practice Address - Phone:626-251-1410
Practice Address - Fax:626-251-1558
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230339163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator