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General NPI Number Information
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NPI Number | 1528098308
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Entity Type | Individual
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Provider Name | LORI JANE MILLS PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 3151 E CENTER STREET EXT
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City | WARSAW
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State | IN
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Zip | 46582-3901
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Country | US
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Telephone | 574-267-3070
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Fax | 574-267-4813
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Provider Business Mailing Address
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Address Line | 9712 N 300 W
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City | HUNTINGTON
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State | IN
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Zip | 46750-9726
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Country | US
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Telephone | 260-344-3435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10000419A
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License Number State | IN
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