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Individual
MILENA T MASK
Active
Individual
MILENA T MASK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041368107
IL
363LF0000X
Family Nurse Practitioner
209014505
IL
363LF0000X
Family Nurse Practitioner
Primary
RN304192
GA
Other
Enumeration date
10/13/2016
Last updated
09/27/2021
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