Millet, Kevin Jon

Millet, Kevin Jon is an individual health care provider with primary practice located at 9674 Archibald Ave Ste 125 , Rancho Cucamonga CA 91730-7944. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Millet, Kevin Jon can be contacted via phone (909) 296-8930.

Contact Information

Primary practice address
9674 Archibald Ave Ste 125 Rancho Cucamonga CA 91730-7944
Phone: (909) 296-8930
Fax: (909) 296-8935
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN543799 California

Profile Details

NPI number 1083699854
LBN Legal business name Millet, Kevin Jon
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated May 8th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083699854 NPPES
California MEDICAID RN5437990

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