Individual
SHELDON E MILLICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11 JOHN MADDOX DR NW, ROME, GA 30165-1413
(706) 295-3992
Mailing address
9639 WAYCROSS CIR, OOLTEWAH, TN 37363-9451
(423) 315-9542
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
APN12203
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
RN105739
TN
367500000X
Certified Registered Nurse Anesthetist
RN128491
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4137599
BCBSTN
TN
Enumeration date
09/22/2006
Last updated
11/27/2012
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