Provider Demographics
NPI:1194423194
Name:CORLEY-MILNER, JANTENEE A'SHANYSE
Entity type:Individual
Prefix:
First Name:JANTENEE
Middle Name:A'SHANYSE
Last Name:CORLEY-MILNER
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 1:29633 TWO HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92585-9286
Mailing Address - Country:US
Mailing Address - Phone:619-929-4795
Mailing Address - Fax:
Practice Address - Street 1:29633 TWO HARBOR LN
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92585-9286
Practice Address - Country:US
Practice Address - Phone:619-929-4795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula