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KOURTLAND BLAIR MCMILLAN
NPI 1255196697
Peer Specialist in Wagner, OK

Active since February 15, 2024
215 NE 1ST STREET, WAGNER, OK 74467(918) 201-4333 Get Directions Write a Review

NPPES record last updated: February 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kourtland Blair Mcmillan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOURTLAND BLAIR MCMILLAN (NPI 1255196697) is an individual peer specialist in Wagner, Oklahoma and active in the NPI registry since February 2024. He maintains a secondary practice location in Wagoner.

NPPES Registry Identity

NPI1255196697
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameKOURTLAND BLAIR MCMILLAN
Location Address215 NE 1ST STREETWagner, OK 74467-6928
Mailing Address215 Ne 1st StWagoner, OK 74467-4439
Phone(918) 201-4333
Sole ProprietorYes
Enumeration DateFebruary 15, 2024
NPPES CertifiedFebruary 15, 2024
✔ NPI 1255196697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
215 NE 1ST STREET, Wagner, OK 74467
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Secondary Practice Location 1

Location 1215 NE 1st StWagoner, OK 74467-4439 · Phone (918) 201-4333

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kourtland Mcmillan's NPI number?

The NPI number for Kourtland Mcmillan is 1255196697. It was assigned to this individual provider in the NPPES registry on February 15, 2024.

Where is Kourtland Mcmillan located?

Kourtland Mcmillan practices at 215 NE 1st Street, Wagner, OK 74467. The listed phone number is (918) 201-4333.

What is Kourtland Mcmillan's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kourtland Mcmillan was last updated on February 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.