=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831075837
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSANNA WHITTEN MILLS DNP, FNP-C, BSN, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2025
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 855 JESSIS MEADOW DR
-----------------------------------------------------
City | WEST BOUNTIFUL
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84087-1946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-563-6459
-----------------------------------------------------
Fax | 210-563-6459
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 855 JESSIS MEADOW DR
-----------------------------------------------------
City | WEST BOUNTIFUL
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84087-1946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-563-6459
-----------------------------------------------------
Fax | 210-563-6459
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11843852-4405
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------