Individual
BLAKE MCMILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
101 BACON ST, PAWTUCKET, RI 02860-5542
(401) 722-3560
(401) 722-3593
Mailing address
325 W 45TH ST APT 803A, NEW YORK, NY 10036-0077
(512) 983-8552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
798064
NY
163W00000X
Registered Nurse
82250
RI
163W00000X
Registered Nurse
916743
TX
Other
Enumeration date
05/21/2021
Last updated
03/27/2026
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