Provider Demographics
NPI:1326644261
Name:MILLS, KAYLA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:COTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:449 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:449 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2029
Practice Address - Country:US
Practice Address - Phone:207-772-1928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR69328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist