Provider Demographics
NPI:1437886199
Name:MCMILLIAN, TORIE LAVERNE (MSN,APRN,A-GNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TORIE
Middle Name:LAVERNE
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:MSN,APRN,A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3863 HIGHWAY 138 SE # 1197
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-4143
Mailing Address - Country:US
Mailing Address - Phone:336-478-5924
Mailing Address - Fax:
Practice Address - Street 1:3863 HIGHWAY 138 SE # 1197
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-4143
Practice Address - Country:US
Practice Address - Phone:336-478-5924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208119207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine