Provider Demographics
NPI:1982873725
Name:MILLEN, KATHY A (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:A
Last Name:MILLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HOLLY CT
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38558-2885
Mailing Address - Country:US
Mailing Address - Phone:931-707-0341
Mailing Address - Fax:
Practice Address - Street 1:131 S WEBB AVE
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-8452
Practice Address - Country:US
Practice Address - Phone:931-484-6196
Practice Address - Fax:931-707-2579
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN161532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse