=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538952577
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOLLEE MAXWELL MILLS RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2025
-----------------------------------------------------
Last Update Date | 05/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 DAWSON DR
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22602-5307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-263-0811
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 116 IRONWEED DR
-----------------------------------------------------
City | LAKE FREDERICK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22630-2255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-538-6823
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | 736054
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------