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NPI Code Detail

MEDICARE: STACY MAYRENE MILLS APRN

MEDICARE:   STACY MAYRENE MILLS  APRN
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
1363L00000XNurse PractitionerAPRN2748802FL

General Provider Information

NPI Number : 1679321970
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY MAYRENE MILLS APRN
Provider Business Mailing Address
First Line : 17504 PRESERVE WALK LN
Second Line :
City : TAMPA
State : FL
Zip : 33647-3243
Country : US
Telephone Number : 813-549-2299
Fax Number :
Provider Business Practice Location Address
First Line : 17504 PRESERVE WALK LN
Second Line :
City : TAMPA
State : FL
Zip : 33647-3243
Country : US
Telephone Number : 813-549-2299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2024
Last Update Date : 05/10/2024

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Directions to “ STACY MAYRENE MILLS APRN” Practice Location

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