Provider Demographics
NPI:1215215256
Name:MCMILLIN, JENNIFER LIGGETT (MSN, CNP)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LIGGETT
Last Name:MCMILLIN
Suffix:
Gender:F
Credentials:MSN, CNP
Other - Prefix:
Other - First Name:JENNIFFER
Other - Middle Name:ELIZABETH
Other - Last Name:LIGGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CNP
Mailing Address - Street 1:3239 STATE RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2549
Mailing Address - Country:US
Mailing Address - Phone:330-923-4500
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:3239 STATE RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2549
Practice Address - Country:US
Practice Address - Phone:330-923-4500
Practice Address - Fax:330-634-1329
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12468363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health