Individual
MS. ANDREA L MILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRD CD REGISTERED CE
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1899029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107933
SECURITY HEALTH PLAN
WI
Enumeration date
07/11/2006
Last updated
12/10/2018
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