Provider Demographics
NPI:1982893707
Name:MCMILLIAN, JOANNE (RD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MCMILLIAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VIRGINIA RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045
Mailing Address - Country:US
Mailing Address - Phone:973-299-1932
Mailing Address - Fax:973-983-2363
Practice Address - Street 1:25 POCONO RD
Practice Address - Street 2:SAINT CLARES HOSPITAL
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-625-6634
Practice Address - Fax:973-983-2363
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ814482133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered