Healthcare Provider Details

I. General information

NPI: 1225953763
Provider Name (Legal Business Name): MILLS ELAINE UNDERWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 W SCHROCK RD
WESTERVILLE OH
43081-2890
US

IV. Provider business mailing address

1661 CARDIFF RD
COLUMBUS OH
43221-3911
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-7570
  • Fax: 614-355-7580
Mailing address:
  • Phone: 614-551-0049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: