Provider Demographics
NPI:1477076057
Name:MCMILLAN, BRITTANY NYCOLE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NYCOLE
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 1:296 BEAUVOIR RD # 100-156
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4051
Mailing Address - Country:US
Mailing Address - Phone:228-209-4348
Mailing Address - Fax:
Practice Address - Street 1:296 BEAUVOIR RD # 100-156
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4051
Practice Address - Country:US
Practice Address - Phone:228-209-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018214Medicaid