Provider Demographics
NPI:1376607705
Name:MCMILLAN, STEFEN DEWITT (RN)
Entity Type:Individual
Prefix:
First Name:STEFEN
Middle Name:DEWITT
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:DEWITT
Other - Last Name:MCMILLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:22062 CHELSY PAIGE SQ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993-7105
Practice Address - Country:US
Practice Address - Phone:888-463-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN180623163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse