Provider Demographics
NPI:1275264046
Name:MCMILLIN, RYLEIGH RENEE
Entity Type:Individual
Prefix:MISS
First Name:RYLEIGH
Middle Name:RENEE
Last Name:MCMILLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SENIOR DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:OH
Mailing Address - Zip Code:44837-1153
Mailing Address - Country:US
Mailing Address - Phone:419-681-4777
Mailing Address - Fax:
Practice Address - Street 1:216 TOWNLINE ROAD 12
Practice Address - Street 2:
Practice Address - City:NORTH FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:44855-9666
Practice Address - Country:US
Practice Address - Phone:567-224-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385HR2060X
OH602384890721385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH215415186871OtherBLS PROVIDER - FISHER TITUS MEDICAL CENTER
OH602384890721OtherSTNA - OHIO DEPARTMENT OF HEALTH