Provider Demographics
NPI:1063133569
Name:MILLIS, CATLYN ANNE APPELGATE
Entity type:Individual
Prefix:MRS
First Name:CATLYN
Middle Name:ANNE APPELGATE
Last Name:MILLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 BOOTSPUR DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4470
Mailing Address - Country:US
Mailing Address - Phone:702-557-3862
Mailing Address - Fax:
Practice Address - Street 1:1089 BOOTSPUR DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4470
Practice Address - Country:US
Practice Address - Phone:702-557-3862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor