Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 20303 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20303 | TN |
NPI | 1447607809 |
---|---|
Provider Name | Mrs. Kristen Mcmillen |
First Address | Lone Tree, CO 80124-5640 |
Second Address | Lone Tree, CO 80124-5640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2016 |
Last Update Date | 09/02/2022 |