BONNIE SUE MCMILLIN


Address: 457 Portland Ave, 3, Saint Paul, MN 55102-2499
Phone: 5072025698

BONNIE SUE MCMILLIN (NPI# 1831486216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1831486216
Entity Type Individual
Full Name BONNIE SUE MCMILLIN
Credential LP
Practice Address 457 Portland Ave
3
Saint Paul
MN 55102-2499
Practice Telephone 5072025698
Mailing Telephone 5072025698
Enumeration Date 2011-07-06
Last Update Date 2011-07-06
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
LP5384 MN Behavioral Health & Social Service Providers

Office Location

Street Address 457 PORTLAND AVE
3
City SAINT PAUL
State MN
Zip Code 55102-2499

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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Competitor

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City SAINT PAUL
Zip Code 55102

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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