Healthcare Provider Details

I. General information

NPI: 1417872763
Provider Name (Legal Business Name): CYDNI MCMILLIAN DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 N RIVERCENTER DR
MILWAUKEE WI
53212-3978
US

IV. Provider business mailing address

208 E RAVINE BAYE RD
BAYSIDE WI
53217-1326
US

V. Phone/Fax

Practice location:
  • Phone: 414-241-0752
  • Fax:
Mailing address:
  • Phone: 414-241-0752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1878233
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: