| Doctor Name: | MS. LISA MCMILLAN |
| NPI Number: | 1871990978 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 9218748 |
| Business Practice Address: | 1661 Redfin Dr Poinciana, FL - 347594709 |
| Business Phone Number: | 4078733662 |
| Business Fax Number: | 8634967260 |
| Mailing Address: | 1661 Redfin Dr, POINCIANA |
| State: | FL |
| Postal Code: | 347594709 |
| Phone Number: | 4078733662 |
| Fax Number: | 8634967260 |
| NPI Enumeration Date: | 12/04/2014 |
| NPI Last Update Date: | 12/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | 9218748 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |