Individual
MRS. MELISSA KELLY MILICEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
304 JANET ST STE B, VALDOSTA, GA 31602-2643
(229) 375-0747
(229) 389-2274
Mailing address
5715 GARDENIA CIR, LAKE PARK, GA 31636-3168
(229) 886-9431
(229) 389-2274
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN217925
GA
363LA2100X
Acute Care Nurse Practitioner
RN217925
GA
Other
Enumeration date
10/03/2016
Last updated
05/23/2020
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