Provider Demographics
NPI:1720544729
Name:MILAM, FELICIA DIANE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:DIANE
Last Name:MILAM
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 S FRASER ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4534
Mailing Address - Country:US
Mailing Address - Phone:720-280-8164
Mailing Address - Fax:
Practice Address - Street 1:320 MARGIE DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7817
Practice Address - Country:US
Practice Address - Phone:478-333-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN073291163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse