Provider Demographics
NPI:1336034818
Name:MILLS, JESSICA NICOLE (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 WELCH CT
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-4314
Mailing Address - Country:US
Mailing Address - Phone:864-494-4403
Mailing Address - Fax:864-494-4403
Practice Address - Street 1:750 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-5348
Practice Address - Country:US
Practice Address - Phone:864-582-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily