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NPI Code Detail

MEDICARE: MS. PAMELLA MARIE MCMILLAN M.A.

MEDICARE: MS. PAMELLA MARIE MCMILLAN M.A.
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
1231H00000XAudiologistAUD0054AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255478137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAMELLA MARIE MCMILLAN M.A.
Provider Business Mailing Address
First Line : 8026 E CLARENDON AVE
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-4856
Country : US
Telephone Number : 480-994-9122
Fax Number :
Provider Business Practice Location Address
First Line : 1200 W SPEEDWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2326
Country : US
Telephone Number : 520-770-3217
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/09/2007

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