Individual
STACEY MCMILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN, CRNFA, CNOR
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Mailing address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
658427
CA
Other
Enumeration date
05/08/2026
Last updated
05/08/2026
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