Provider Demographics
NPI:1770683401
Name:MCMILLAN, KATHRYN HARRISON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:HARRISON
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6014 HIGHWAY 21 S STE P
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5573
Mailing Address - Country:US
Mailing Address - Phone:912-826-0250
Mailing Address - Fax:912-826-0717
Practice Address - Street 1:6014 HIGHWAY 21 S
Practice Address - Street 2:SUITE P
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5572
Practice Address - Country:US
Practice Address - Phone:912-826-0250
Practice Address - Fax:912-826-0717
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist