Provider Demographics
NPI:1205825189
Name:MILLS, JANE E (CNM)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
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 1:12 HIGH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7676
Mailing Address - Country:US
Mailing Address - Phone:207-795-5770
Mailing Address - Fax:207-795-5779
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:STE 200
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7676
Practice Address - Country:US
Practice Address - Phone:207-795-5770
Practice Address - Fax:207-795-5779
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAM082011367A00000X
MECNM82011163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME249550099Medicaid
ME249550099Medicaid