MEDICARE: TUIZ JUANDA MILLS

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	374U00000X	Home Health Aide	47255	VA

General Provider Information

NPI Number	:	1871157792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUIZ JUANDA MILLS

Provider Business Mailing Address
First Line	:	4740 W NORFOLK RD
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2228
Country	:	US
Telephone Number	:	757-582-2990
Fax Number	:

Provider Business Practice Location Address
First Line	:	4740 W NORFOLK RD
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-2228
Country	:	US
Telephone Number	:	757-582-2990
Fax Number	:

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

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	04/25/2019

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Directions to “ TUIZ JUANDA MILLS ” Practice Location

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