Provider Demographics
NPI:1912872219
Name:MILLAN, OLIVER
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:
Last Name:MILLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 KASHMIRE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7613
Mailing Address - Country:US
Mailing Address - Phone:719-291-8020
Mailing Address - Fax:
Practice Address - Street 1:2806 JANITELL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4141
Practice Address - Country:US
Practice Address - Phone:719-291-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20256001250374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician