Basic Information
| Provider Information | |||||||||
| NPI: | 1649510421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILUM | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 579 ST HWY J | ||||||||
| Address2: | |||||||||
| City: | HAYTI | ||||||||
| State: | MO | ||||||||
| PostalCode: | 63851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733599840 | ||||||||
| FaxNumber: | 5733596200 | ||||||||
| Practice Location | |||||||||
| Address1: | 925 HIGHWAY V V | ||||||||
| Address2: | |||||||||
| City: | KENNETT | ||||||||
| State: | MN | ||||||||
| PostalCode: | 638570071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738885925 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2013 | ||||||||
| LastUpdateDate: | 02/15/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 032856 | MO | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.