Healthcare Provider Details

I. General information

NPI: 1831073808
Provider Name (Legal Business Name): LINDSEY MILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PROFESSIONAL PL STE 101
BRIDGEPORT WV
26330-4599
US

IV. Provider business mailing address

213 WAVERLY WAY
CLARKSBURG WV
26301-4046
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax:
Mailing address:
  • Phone: 304-694-0210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number123529
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number123529
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: