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General NPI Number Information
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NPI Number | 1720810898
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Entity Type | Individual
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Provider Name | BRENDA K MILLS-LAYNE
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Gender | Female
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 901 HARRY S TRUMAN DR N
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City | LARGO
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State | MD
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Zip | 20774-5477
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Country | US
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Telephone | 904-372-3943
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Fax | 904-212-1618
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Provider Business Mailing Address
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Address Line | 7751 BELFORT PKWY STE 120
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6921
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Country | US
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Telephone | 904-372-3943
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Fax | 904-212-1618
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R237181
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R237181
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | R237181
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License Number State | MD
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