Individual
DAVID MICHAEL MCMILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5482 HIGHWAY 15 N, ECRU, MS 38841-8471
(662) 488-8799
(662) 488-8729
Mailing address
5482 HIGHWAY 15 N, ECRU, MS 38841-8471
(662) 488-8799
(662) 488-8729
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R858462
MS
363LA2100X
Acute Care Nurse Practitioner
Primary
R858462
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01187262
—
MS
Enumeration date
01/29/2016
Last updated
04/01/2020
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