Provider Demographics
NPI:1780016915
Name:MCMILLAN, BENJAMIN JOEL (NP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JOEL
Last Name:MCMILLAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300A E MCKAY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-9037
Mailing Address - Country:US
Mailing Address - Phone:910-862-8677
Mailing Address - Fax:910-872-0283
Practice Address - Street 1:300A E MCKAY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9037
Practice Address - Country:US
Practice Address - Phone:910-862-8677
Practice Address - Fax:910-872-0283
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006315363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner