MEDICARE: AMY C MILLS FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024176089	VA

General Provider Information

NPI Number	:	1538658703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY C MILLS FNP

Provider Business Mailing Address
First Line	:	PO BOX 1303
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-1303
Country	:	US
Telephone Number	:	434-404-3970
Fax Number	:	434-404-3371

Provider Business Practice Location Address
First Line	:	1054 BOLD SPRINGS RD
Second Line	:
City	:	SOUTH BOSTON
State	:	VA
Zip	:	24592-6983
Country	:	US
Telephone Number	:	434-404-3970
Fax Number	:	434-404-3371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	07/29/2025

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