Provider Demographics
NPI:1235642729
Name:MILLAR, JUSTYN LAMB (DNP)
Entity Type:Individual
Prefix:DR
First Name:JUSTYN
Middle Name:LAMB
Last Name:MILLAR
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:JUSTYN
Other - Middle Name:ELIZABETH
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DRJUSTYN MILLAR,DNP
Mailing Address - Street 1:4460 MOUNTAINDALE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 CAHABA PARK CIR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5087
Practice Address - Country:US
Practice Address - Phone:205-335-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-162969363LP0200X
SC20171877363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics