Provider Demographics
NPI:1669815957
Name:MCMILLAN, CHRISTINA MICHELLE WRAY (WHNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MICHELLE WRAY
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MICHELLE
Other - Last Name:WRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:2865 LYNNHAVEN DR STE A4
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2865 LYNNHAVEN DR STE A4
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1542
Practice Address - Country:US
Practice Address - Phone:757-496-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704234558363LW0102X
VA0024170041363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health