MEDICARE: DEONDRA 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548728785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEONDRA MILLS

Provider Business Mailing Address
First Line	:	5670 WINNESTE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45232-1270
Country	:	US
Telephone Number	:	513-675-8564
Fax Number	:

Provider Business Practice Location Address
First Line	:	5670 WINNESTE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45232-1270
Country	:	US
Telephone Number	:	513-675-8564
Fax Number	:

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

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	03/06/2019

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Directions to “ DEONDRA MILLS ” Practice Location

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