Provider Demographics
NPI:1326698150
Name:MCMILLAN, LACHISH JASMIN MCCLURKIN (RN)
Entity type:Individual
Prefix:
First Name:LACHISH
Middle Name:JASMIN MCCLURKIN
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LACHISH
Other - Middle Name:JASMIN
Other - Last Name:MCCLURKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4500 8TH DIVISION RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29207-5700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 8TH DIVISION RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207-5700
Practice Address - Country:US
Practice Address - Phone:803-972-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily