Provider Demographics
NPI:1124179338
Name:MACMILLAN, BARBARA P (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:P
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6382 ROADRUNNER LOOP NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-5150
Mailing Address - Country:US
Mailing Address - Phone:505-994-4823
Mailing Address - Fax:505-994-2009
Practice Address - Street 1:1650 UNIVERSITY BLVD NE
Practice Address - Street 2:PATIENT EDUCATION SUITE 505
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1726
Practice Address - Country:US
Practice Address - Phone:505-272-3038
Practice Address - Fax:505-272-6591
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR46430163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR46430OtherNURSING LICENSE