Provider Demographics
NPI:1013219856
Name:MILLARD, SANDRA JOY (RN)
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:JOY
Last Name:MILLARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3800 CITIBANK CTR
Mailing Address - Street 2:BUILDING C 1ST FLOOR
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9559
Mailing Address - Country:US
Mailing Address - Phone:813-604-4333
Mailing Address - Fax:813-604-4337
Practice Address - Street 1:3800 CITIBANK CTR
Practice Address - Street 2:BUILDING C 1ST FLOOR
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9559
Practice Address - Country:US
Practice Address - Phone:813-604-4333
Practice Address - Fax:813-604-4337
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2030392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily