Provider Demographics
NPI:1972639573
Name:MILAM, ANNE LAURIE (APN)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:LAURIE
Last Name:MILAM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:LAURIE
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:7303 MARYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1530
Mailing Address - Country:US
Mailing Address - Phone:281-363-1059
Mailing Address - Fax:
Practice Address - Street 1:2013 KELLY LN
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7879
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253746163W00000X, 363LF0000X
TXAP115508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1972639573Medicaid