Provider Demographics
NPI:1952101032
Name:RAE, MILCAH
Entity type:Individual
Prefix:
First Name:MILCAH
Middle Name:
Last Name:RAE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42736 ELWOOD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:NE
Mailing Address - Zip Code:68937-5613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:42736 ELWOOD LAKE DR
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:NE
Practice Address - Zip Code:68937-5613
Practice Address - Country:US
Practice Address - Phone:308-991-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider