Provider Demographics
NPI:1831252592
Name:MILNER, ROSIE T (NP)
Entity type:Individual
Prefix:MISS
First Name:ROSIE
Middle Name:T
Last Name:MILNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46807-1103
Mailing Address - Country:US
Mailing Address - Phone:260-458-8414
Mailing Address - Fax:260-458-8414
Practice Address - Street 1:2315 BROADWAY
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46807-1103
Practice Address - Country:US
Practice Address - Phone:260-458-8414
Practice Address - Fax:260-458-8414
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000514A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily