Healthcare Provider Details

I. General information

NPI: 1013722412
Provider Name (Legal Business Name): SHARON MARIE MILLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 BRECKINRIDGE BLVD STE 160
DULUTH GA
30096-7601
US

IV. Provider business mailing address

1353 GEORGIA AVE
SOPERTON GA
30457-2631
US

V. Phone/Fax

Practice location:
  • Phone: 678-400-3600
  • Fax: 678-400-3603
Mailing address:
  • Phone: 478-290-5103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN218316
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN218316
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: