Individual
STACY MCMILLAN-MAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 CASCADE AVE, DALLAS, TX 75224-1230
(214) 213-7730
Mailing address
1215 CASCADE AVE, DALLAS, TX 75224-1230
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1002940
TX
Other
Enumeration date
02/09/2024
Last updated
05/31/2024
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