Individual
MARY-COLLEEN MILLAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
681 HIOAKS RD, SUITE H, RICHMOND, VA 23225-4043
(804) 560-0490
Mailing address
681 HIOAKS RD, SUITE H, RICHMOND, VA 23225-4043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168480
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588992200
—
VA
Enumeration date
11/19/2009
Last updated
06/10/2010
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