1588981617 NPI number — MS. LINDSAY BETH MILLIGAN PA-C

Table of content: MS. LINDSAY BETH MILLIGAN PA-C (NPI 1588981617)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588981617 NPI number — MS. LINDSAY BETH MILLIGAN PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLIGAN
Provider First Name:
LINDSAY
Provider Middle Name:
BETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'DONNELL
Provider Other First Name:
LINDSAY
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588981617
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
627 RANDALL ROAD
Provider Second Line Business Mailing Address:
HAMPDEN COUNTY CORRECTIONAL CENTER, HEALTH SERVICES
Provider Business Mailing Address City Name:
LUDLOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-547-8000
Provider Business Mailing Address Fax Number:
413-589-0912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
627 RANDALL ROAD
Provider Second Line Business Practice Location Address:
HAMPDEN COUNTY CORRECTIONAL CENTER, HEALTH SERVICES
Provider Business Practice Location Address City Name:
LUDLOW
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-547-8000
Provider Business Practice Location Address Fax Number:
413-589-0912
Provider Enumeration Date:
04/29/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  PA3949 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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