Provider Demographics
NPI:1023690674
Name:NP'S MILLENNIAL CARE PLLC
Entity type:Organization
Organization Name:NP'S MILLENNIAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:MILLEN
Authorized Official - Suffix:SR
Authorized Official - Credentials:ANP-BC
Authorized Official - Phone:910-995-0066
Mailing Address - Street 1:121 HIDDEN ACRES CIR
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-9717
Mailing Address - Country:US
Mailing Address - Phone:910-995-0066
Mailing Address - Fax:949-561-5037
Practice Address - Street 1:1219 ROCKINGHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4925
Practice Address - Country:US
Practice Address - Phone:910-995-0066
Practice Address - Fax:949-561-5037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1710182209Medicaid