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1013417922
TI'ARRA DOMINIQUE LEE MCMILLIAN
TAMPA, FL
NPI
1013417922
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: FL PN5226312)
Enumeration Date
2018-02-16
Last Update Date
2018-02-16
Business Address
MS. TI'ARRA DOMINIQUE LEE MCMILLIAN LPN
2212 E HENRY AVE
TAMPA, FL 33610-4433
Phone number: 813-239-8069
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Mailing Address
MS. TI'ARRA DOMINIQUE LEE MCMILLIAN LPN
5038 TEMPLE HEIGHTS RD APT 30
TAMPA, FL 33617-4626
Phone number: 813-451-5605
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