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NPI 1699162792

NPI 1699162792 : SARA L MCMILLAN RN, CDE : WILLIAMSVILLE, NY

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General NPI Number Information
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    NPI Number           |    1699162792
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    Entity Type          |    Individual 
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    Provider Name        |    SARA L MCMILLAN RN, CDE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/16/2015
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    Last Update Date     |    04/16/2015
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Provider Practice Location Address
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    Address Line         |    356 SUNRISE BLVD 
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    City                 |    WILLIAMSVILLE
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    State                |    NY
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    Zip                  |    14221-3127
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    Country              |    US
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    Telephone            |    716-880-0852
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    356 SUNRISE BLVD 
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    City                 |    WILLIAMSVILLE
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    State                |    NY
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    Zip                  |    14221-3127
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    Country              |    US
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    Telephone            |    716-880-0852
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WD0400X
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    Taxonomy Name        |    Diabetes Educator Registered Nurse
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    License Number       |    645406
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    License Number State |    NY
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