Provider Demographics
NPI:1801008016
Name:MILLIKEN, DONNA (AP, DOM, RN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:MILLIKEN
Suffix:
Gender:F
Credentials:AP, DOM, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SEA DUNES DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-3361
Mailing Address - Country:US
Mailing Address - Phone:321-725-4095
Mailing Address - Fax:
Practice Address - Street 1:18 S RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4300
Practice Address - Country:US
Practice Address - Phone:321-514-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2273171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist