Individual
MS. SALLY TACHIAS MCMILLIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3285 E. SPARROW AVE, FLAGSTAFF, AZ 86004
(928) 773-4112
(928) 773-4108
Mailing address
400 SKYVIEW ST, FLAGSTAFF, AZ 86004
(928) 526-1231
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
059325
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
556912
—
AZ
Enumeration date
05/03/2007
Last updated
07/08/2007
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