Individual
MS. LISA MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1661 REDFIN DR, POINCIANA, FL 34759-4709
(407) 873-3662
(863) 496-7260
Mailing address
1661 REDFIN DR, POINCIANA, FL 34759-4709
(407) 873-3662
(863) 496-7260
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
9218748
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12559
ASSISTED LIVING FACILITY
FL
Enumeration date
12/04/2014
Last updated
12/04/2014
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