Malcolm, Millicent M

Malcolm, Millicent M is an individual health care provider with primary practice located at 520 Saybrook Rd Suite N100, Middletown CT 06457-4700. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Malcolm, Millicent M can be contacted via phone (860) 344-1801.

Contact Information

Primary practice address
520 Saybrook Rd Suite N100 Middletown CT 06457-4700
Phone: (860) 344-1801
Fax: (860) 358-8657
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 002258 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 002258 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 002258 Connecticut

Profile Details

NPI number 1255418414
LBN Legal business name Malcolm, Millicent M
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Apr 12th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255418414 NPPES
Connecticut MEDICAID 4208296
Connecticut MEDICAID 004208296

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