Provider Demographics
NPI:1366542870
Name:MCMILLAN, HOWEIDA ALEXIS
Entity type:Individual
Prefix:MRS
First Name:HOWEIDA
Middle Name:ALEXIS
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 TIM TAM TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-1931
Mailing Address - Country:US
Mailing Address - Phone:850-893-5717
Mailing Address - Fax:
Practice Address - Street 1:110 PAUL RUSSELL RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-6977
Practice Address - Country:US
Practice Address - Phone:850-656-9189
Practice Address - Fax:850-671-3981
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0018153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist