Individual
PHYLLIS A MILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5743 PRESTON HWY, LOUISVILLE, KY 40219-1305
(502) 444-6008
Mailing address
PO BOX 740017, ATLANTA, GA 30374-0017
(312) 733-9730
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
00220316
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3011435
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5019969
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
11/07/2012
Last updated
06/04/2024
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