Provider Demographics
NPI:1841716859
Name:MILLIRON, JENNIFER (LM, CPM)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MILLIRON
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 CREEK WOOD CT
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4758
Mailing Address - Country:US
Mailing Address - Phone:469-583-7951
Mailing Address - Fax:
Practice Address - Street 1:2713 CREEK WOOD CT
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-4758
Practice Address - Country:US
Practice Address - Phone:469-583-7951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX99325176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program