MRS. MELISSA KELLY MILICEVIC (NPI# 1366991374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366991374 |
| Entity Type | Individual |
| Full Name | MRS. MELISSA KELLY MILICEVIC |
| Other Name | MRS. MELISSA KELLY VAN HORN |
| Credential | NP |
| Practice Address |
304 Janet St Ste B Valdosta GA 31602-2643 |
| Mailing Address |
5715 Gardenia Cir Lake Park GA 31636-3168 |
| Practice Telephone | 2293750747 |
| Practice Fax Number | 2293892274 |
| Mailing Telephone | 2298869431 |
| Mailing Fax Number | 2293892274 |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2020-05-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN217925 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN217925 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
304 JANET ST STE B |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285101964 | Anne Marie Diaz | Nurse Practitioner | 410 Connell Road Suite T, Valdosta, GA 31602-3160 | 2018-10-31 |
| 1437648235 | Whitney Renee Apperson | Nurse Practitioner | 2418 N Oak St Ste G, Valdosta, GA 31602-2575 | 2018-05-07 |
| 1184805400 | Pamela W Powell | Nurse Practitioner | 4711 Woodland Pt, Valdosta, GA 31602-0823 | 2007-11-15 |
| 1346326048 | Gina S Dungan | Nurse Practitioner | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| 1356318265 | Thomas Alexandeer Mackean | Nurse Practitioner | 704 Gil Harbin Industrial Blvd, Valdosta, GA 31601-6513 | 2006-03-01 |
| 1487260949 | Joshua Caleb Vining | Nurse Practitioner | 3200 N Ashley St Ste C, Valdosta, GA 31602-5911 | 2020-09-21 |
| 1164081311 | Mary Deason Perritt | Nurse Practitioner | 2700 N Oak St Bldg B, Valdosta, GA 31602-5903 | 2019-06-11 |
| 1689130312 | Kala Jo Bugg | Nurse Practitioner | 2501 N Patterson St, Valdosta, GA 31602-1785 | 2019-02-19 |
| 1104382092 | Meredith Emily Decesare | Nurse Practitioner | 2263 Pineview Dr, Valdosta, GA 31602-7316 | 2019-02-15 |
| 1700353547 | Joseph Bret Evans | Nurse Practitioner | 410 Connell Rd, Valdosta, GA 31602-1898 | 2018-10-30 |
| Find all providers in VALDOSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.