Provider Demographics
NPI:1134149503
Name:MILNER, RENE BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:BRIAN
Last Name:MILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024-9450
Mailing Address - Country:US
Mailing Address - Phone:715-483-5133
Mailing Address - Fax:715-483-3904
Practice Address - Street 1:205 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-9450
Practice Address - Country:US
Practice Address - Phone:715-483-5133
Practice Address - Fax:715-483-3904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37380-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN166L2MIOtherMN BLUE CROS INDIVIDUAL #
MNHP18168OtherHEALTHPARTNERS PID#
MN500516700Medicaid
MN95909OtherHEALTHPARTNERS FIN#
MN166L1MIOtherMN BLUE CROSS GROUP #
WI32187800Medicaid
WI550806899010OtherWI BLUE CROSS ID #
WI550806899010OtherWI BLUE CROSS ID #
WI000049007Medicare PIN