Provider Demographics
NPI:1972165397
Name:MILLNER, NATISHA RENEE
Entity type:Individual
Prefix:
First Name:NATISHA
Middle Name:RENEE
Last Name:MILLNER
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 1:301 CATHY DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2827
Mailing Address - Country:US
Mailing Address - Phone:434-421-9900
Mailing Address - Fax:
Practice Address - Street 1:301 CATHY DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-2827
Practice Address - Country:US
Practice Address - Phone:434-421-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities