Provider Demographics
NPI:1679383616
Name:VIRTUE-MILLIGAN, SEANEE KEANNA (PN)
Entity type:Individual
Prefix:MRS
First Name:SEANEE
Middle Name:KEANNA
Last Name:VIRTUE-MILLIGAN
Suffix:
Gender:F
Credentials:PN
Other - Prefix:MRS
Other - First Name:SEANEE
Other - Middle Name:
Other - Last Name:VIRTUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4813 RIDGE RD STE 113-644
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6117
Mailing Address - Country:US
Mailing Address - Phone:470-923-4013
Mailing Address - Fax:
Practice Address - Street 1:4813 RIDGE RD STE 113-644
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6117
Practice Address - Country:US
Practice Address - Phone:470-923-4013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN081275164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse