Healthcare Provider Details

I. General information

NPI: 1467676577
Provider Name (Legal Business Name): AMY HILBURN MILLS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 S FOREST AVE
LUVERNE AL
36049-7306
US

IV. Provider business mailing address

1560 CARTER RD
GOSHEN AL
36035-6720
US

V. Phone/Fax

Practice location:
  • Phone: 334-335-3383
  • Fax: 334-335-3078
Mailing address:
  • Phone: 334-303-1407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-079830
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: