Doctor Name: | KAYCIE SINK MILLARD |
NPI Number: | 1790189090 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 50.004126 |
Business Practice Address: | 7324 Yankee Rd Ste B Liberty Twp, OH - 450449378 |
Business Phone Number: | 5137797716 |
Business Fax Number: | 5139597163 |
Mailing Address: | 7324 Yankee Rd Ste B, LIBERTY TWP |
State: | OH |
Postal Code: | 450449378 |
Phone Number: | 5137797716 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2014 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 50.004126 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |