Provider Demographics
NPI:1750154852
Name:MILAM, TOSHIA NICOLE (CRNP MSN, FNP-BC)
Entity type:Individual
Prefix:MISS
First Name:TOSHIA
Middle Name:NICOLE
Last Name:MILAM
Suffix:
Gender:F
Credentials:CRNP MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 CHILTON ST
Mailing Address - Street 2:
Mailing Address - City:THORSBY
Mailing Address - State:AL
Mailing Address - Zip Code:35171-7850
Mailing Address - Country:US
Mailing Address - Phone:205-217-0040
Mailing Address - Fax:
Practice Address - Street 1:108 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:CLANTON
Practice Address - State:AL
Practice Address - Zip Code:35045-2332
Practice Address - Country:US
Practice Address - Phone:205-755-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine