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General NPI Number Information
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NPI Number | 1891144796
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Entity Type | Individual
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Provider Name | MAXINE ELIZABETH MILLARD RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 13386 E 42ND DR
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City | YUMA
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State | AZ
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Zip | 85367-6111
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Country | US
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Telephone | 928-627-8871
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Fax |
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Provider Business Mailing Address
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Address Line | 13386 E 42ND DR
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City | YUMA
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State | AZ
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Zip | 85367-6111
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Country | US
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Telephone | 928-345-1833
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN150247
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License Number State | AZ
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