Provider Demographics
NPI:1043846397
Name:MILLS, ADRIAN (CNM)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 THE MEADOWS PKWY
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4727
Mailing Address - Country:US
Mailing Address - Phone:682-554-2281
Mailing Address - Fax:
Practice Address - Street 1:1229 E PLEASANT RUN RD
Practice Address - Street 2:STE 127
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4211
Practice Address - Country:US
Practice Address - Phone:682-554-2281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145446367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife