MEDICARE: JILLIAN M MILLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9344038	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN9344038	OTHER	FL	FLORIDA BOARD OF NURSING
2	ARNP9344038	OTHER	FL	ARNP LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154763209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN M MILLS

Provider Business Mailing Address
First Line	:	2260 S FERDON BLVD # 262
Second Line	:
City	:	CRESTVIEW
State	:	FL
Zip	:	32536-8457
Country	:	US
Telephone Number	:	850-960-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	3235 NEWNAN RD
Second Line	:
City	:	GRIFFIN
State	:	GA
Zip	:	30223-7114
Country	:	US
Telephone Number	:	770-441-4049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	08/03/2024

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Directions to “ JILLIAN M MILLS ” Practice Location

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