Provider Demographics
NPI:1114686797
Name:MILLAN, AILEEN (AGACNP-BC)
Entity type:Individual
Prefix:DR
First Name:AILEEN
Middle Name:
Last Name:MILLAN
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4639
Mailing Address - Country:US
Mailing Address - Phone:850-872-8510
Mailing Address - Fax:
Practice Address - Street 1:1836 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4639
Practice Address - Country:US
Practice Address - Phone:850-872-8510
Practice Address - Fax:850-872-7412
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN190727163WC0200X
FLAPRN11033321363LA2200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health