Healthcare Provider Details

I. General information

NPI: 1144851502
Provider Name (Legal Business Name): ALLISON FAYE MILLS DNP, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 NORTH BLVD W
DAVENPORT FL
33837-8990
US

IV. Provider business mailing address

1128 COTTONTOWN MANOR DR APT 204
FOREST VA
24551-2541
US

V. Phone/Fax

Practice location:
  • Phone: 863-421-7600
  • Fax: 863-421-7551
Mailing address:
  • Phone: 434-248-7074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0017146763
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11021997
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0017146763
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: