Healthcare Provider Details

I. General information

NPI: 1104731819
Provider Name (Legal Business Name): DANIELLE MILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 ELMWOOD AVE
ROCHESTER NY
14618-2014
US

IV. Provider business mailing address

16 ROSEDALE ST
ROCHESTER NY
14620-1810
US

V. Phone/Fax

Practice location:
  • Phone: 585-269-4369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN54026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: