Provider Demographics
NPI:1871898759
Name:MCMILLIN, TERESA LEE (PA)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:LEE
Last Name:MCMILLIN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:24571 SILVER CLOUD CT
Mailing Address - Street 2:#202
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6583
Mailing Address - Country:US
Mailing Address - Phone:831-648-8005
Mailing Address - Fax:831-648-7376
Practice Address - Street 1:559 ABBOTT ST
Practice Address - Street 2:#A
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4325
Practice Address - Country:US
Practice Address - Phone:831-648-8005
Practice Address - Fax:831-648-7376
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13216363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical