Healthcare Provider Details

I. General information

NPI: 1952381436
Provider Name (Legal Business Name): NANCY MILLS R.N., C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9811 MALLARD DR SUITE 109
LAUREL MD
20708-3143
US

IV. Provider business mailing address

9811 MALLARD DR SUITE 109
LAUREL MD
20708-3143
US

V. Phone/Fax

Practice location:
  • Phone: 301-776-8000
  • Fax: 301-776-6753
Mailing address:
  • Phone: 301-776-8000
  • Fax: 301-776-6753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR089027
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: