Provider Demographics
NPI:1063273274
Name:MILLEN, MONIKA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:
Last Name:MILLEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 MARION ST
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-1555
Mailing Address - Country:US
Mailing Address - Phone:704-232-0320
Mailing Address - Fax:
Practice Address - Street 1:1908 E FRANKLIN BLVD # 100
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4742
Practice Address - Country:US
Practice Address - Phone:704-271-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019444363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner