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NPI Code Detail

MEDICARE: TRACY MILLS ARNP

MEDICARE: TRACY MILLS ARNP
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
1363L00000XNurse PractitionerAPRN9352533FL
2363LA2200XAdult Health Nurse Practitioner291434OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1291434OTHEROHOH RN LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912161373
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY MILLS ARNP
Provider Business Mailing Address
First Line : 1205 MONUMENT RD
Second Line : STE 301
City : JACKSONVILLE
State : FL
Zip : 32225-6482
Country : US
Telephone Number : 216-931-1413
Fax Number :
Provider Business Practice Location Address
First Line : 2500 E 22ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-3204
Country : US
Telephone Number : 216-931-1413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2008
Last Update Date : 01/24/2019

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