Provider Demographics
NPI:1326766270
Name:MCMILLAN, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:MCMILLAN
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 1:6913 OUTLAW CT APT 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-2605
Mailing Address - Country:US
Mailing Address - Phone:407-561-8882
Mailing Address - Fax:
Practice Address - Street 1:6913 OUTLAW CT APT 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-2605
Practice Address - Country:US
Practice Address - Phone:407-561-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care