| NPI | 1699547091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKEELUS MILLIGAN Provider 770-318-0989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2025-08-29 |