Provider Demographics
NPI:1972034197
Name:MILLNER, ADRIENNE E (MD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:E
Last Name:MILLNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:E
Other - Last Name:UPHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:115 CORNELL DR SE UNIT 40337
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87196-0036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MSC 10 5580, 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-3100
Practice Address - Country:US
Practice Address - Phone:434-466-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2024-0127207V00000X
CA174105207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program