Provider Demographics
NPI:1942644984
Name:MCMILLAN, KRISTIN ANN (APNP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ANN
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 N MAYFAIR RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-4400
Mailing Address - Country:US
Mailing Address - Phone:414-773-6300
Mailing Address - Fax:
Practice Address - Street 1:2727 N MAYFAIR RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53222-4400
Practice Address - Country:US
Practice Address - Phone:414-773-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI112672-030163W00000X
WI5271-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse