Provider Demographics
NPI:1821213778
Name:NEWTON MCMILLAN, MARGARET DEANNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:DEANNE
Last Name:NEWTON MCMILLAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:DEANNE
Other - Last Name:HEALIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14330 CULVER DR
Mailing Address - Street 2:CVS CAREMARK/MINUTE CLINIC ATTN CREDENTIALING
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0303
Mailing Address - Country:US
Mailing Address - Phone:401-770-1981
Mailing Address - Fax:
Practice Address - Street 1:14330 CULVER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-0303
Practice Address - Country:US
Practice Address - Phone:949-559-1522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN320758363LF0000X
CACERT 15573363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABJ145WMedicare PIN
CABJ145ZMedicare PIN