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NPI Code Detail

MEDICARE: MISS TAMARA SELINA MCMILLAN MSN, RN, AGACNP-BC

MEDICARE:  MISS TAMARA SELINA MCMILLAN  MSN, RN, AGACNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95023081CA

General Provider Information

NPI Number : 1881391480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TAMARA SELINA MCMILLAN MSN, RN, AGACNP-BC
Provider Business Mailing Address
First Line : 1391 E MADISON AVE
Second Line :
City : EL CAJON
State : CA
Zip : 92021-8568
Country : US
Telephone Number : 619-444-1107
Fax Number :
Provider Business Practice Location Address
First Line : 1391 E MADISON AVE
Second Line :
City : EL CAJON
State : CA
Zip : 92021-8568
Country : US
Telephone Number : 619-444-1107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2023
Last Update Date : 02/14/2023

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Directions to “ MISS TAMARA SELINA MCMILLAN MSN, RN, AGACNP-BC” Practice Location

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