Provider Demographics
NPI:1841568722
Name:PANTER, MILEAH A (NP)
Entity Type:Individual
Prefix:
First Name:MILEAH
Middle Name:A
Last Name:PANTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MILEAH
Other - Middle Name:A
Other - Last Name:NICKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PHELPS MEDICAL GROUP
Mailing Address - Street 2:1315 TIBBALS STREET
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949
Mailing Address - Country:US
Mailing Address - Phone:308-995-6111
Mailing Address - Fax:308-995-4868
Practice Address - Street 1:PHELPS MEDICAL GROUP
Practice Address - Street 2:1315 TIBBALS STREET
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949
Practice Address - Country:US
Practice Address - Phone:308-995-6111
Practice Address - Fax:308-995-4868
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111318363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care