Provider Demographics
NPI:1306193099
Name:WHALEY, MILLICENT COHEN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MILLICENT
Middle Name:COHEN
Last Name:WHALEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MILLICENT
Other - Middle Name:SHEREE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:904-697-4127
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1717 S ORANGE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2944
Practice Address - Country:US
Practice Address - Phone:407-650-7715
Practice Address - Fax:407-650-7124
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9347090367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered