Individual
ANASTASIA BROOKE MILLIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Contact information
Practice address
4521 THOMAS JEFFERSON ST, CALDWELL, ID 83605
(208) 454-4820
Mailing address
4521 THOMAS JEFFERSON ST, CALDWELL, ID 83605-5100
(208) 454-4820
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP987-A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003399100
—
ID
05
—
1669792859
—
ID
Enumeration date
06/10/2010
Last updated
03/23/2022
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