Provider Demographics
NPI:1750646253
Name:MILLNER, PATRICIA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:RENEE
Last Name:MILLNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:MILLNER
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1229 C AVE E
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-4246
Mailing Address - Country:US
Mailing Address - Phone:641-672-3182
Mailing Address - Fax:808-433-1153
Practice Address - Street 1:1229 C AVE E
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-4246
Practice Address - Country:US
Practice Address - Phone:641-672-3182
Practice Address - Fax:808-433-1153
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA48474207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine