Individual provider Active NPI

Nicole M Milliken, CNP

  • Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1114119617
Registry record updated Sep 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704307959 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 482-7246
Fax
(517) 484-7377
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP 09499 OH
Nurse Practitioner 363L00000X 4704307959 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

1540 Lake Lansing Rd Ste G6
Lansing, MI 48912-3757
Phone (517) 482-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000874 MI Practitioner - Nurse Practitioner 1153418835 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704307959MIMDNurse Practitioner
NP 09499OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Michigan Pain Center PLLC CurrentSince Apr 1, 2024 Accepting new patients
Northeast Ohio Cardiovascular Specialists Inc. Past Accepting new patients
Summa Physicians LLC Past Accepting new patients
Summa Physicians LLC Nurse Practitioner PastSince Jul 21, 2024 Accepting new patients

Locations

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1355

205 S Dexter St
Ionia, MI 48846
Phone (517) 482-7246

1200 E Michigan Ave
Lowr
Lansing, MI 48912
Phone (517) 364-5252

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1540 Lake Lansing Rd
Ste G6
Lansing, MI 48912
Phone (517) 482-7246

1540 Lake Lansing Rd
Ste G
Lansing, MI 48912

560 W 465 N
Ste 604
Providence, UT 84332
Phone (435) 753-1600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663372800000",
    "number": "1114119617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD STE G6",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123757",
            "telephone_number": "517-482-7246",
            "fax_number": "517-484-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-482-7246",
            "fax_number": "517-484-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIKEN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP 09499",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704307959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.