Basic Information
| Provider Information | |||||||||
| NPI: | 1891226643 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLING | ||||||||
| FirstName: | MATTHEW | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 FLOWOOD DR STE 400 | ||||||||
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| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019339521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1030 RIVER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019339521 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2017 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R887956 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.