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General NPI Number Information
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NPI Number | 1912887357
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Entity Type | Organization
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Legal Business Name | MILLS FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 510 WYOMING BLVD SW
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City | MILLS
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State | WY
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Zip | 82644
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Country | US
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Telephone | 307-224-6078
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Fax | 307-224-6099
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Provider Business Mailing Address
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Address Line | 12473 POISON SPIDER RD
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City | CASPER
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State | WY
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Zip | 82604-9551
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Country | US
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Telephone | 307-224-6078
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Fax | 307-224-6099
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DR. KIMBERLY DIANE KEARNEY
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Credential | DNP FNP-BC
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Telephone | 307-224-6078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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