Healthcare Provider Details

I. General information

NPI: 1144607748
Provider Name (Legal Business Name): MAUREEN MILLS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2015
Last Update Date: 05/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15204 OMEGA DR SUITE 100
ROCKVILLE MD
20850-4601
US

IV. Provider business mailing address

15204 OMEGA DR SUITE 100
ROCKVILLE MD
20850-4601
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-6750
  • Fax: 301-208-8953
Mailing address:
  • Phone: 301-279-6750
  • Fax: 301-208-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR137763
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberR137763
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: