Provider Demographics
NPI:1629250691
Name:MCMILLIN, SEAN DENELLE (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:SEAN
Middle Name:DENELLE
Last Name:MCMILLIN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 ANGUS CT
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-6537
Mailing Address - Country:US
Mailing Address - Phone:502-241-8459
Mailing Address - Fax:502-241-8459
Practice Address - Street 1:6608 ANGUS CT
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-6537
Practice Address - Country:US
Practice Address - Phone:502-241-8459
Practice Address - Fax:502-241-8459
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1069788163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant