Provider Demographics
NPI:1376227165
Name:MILLS, HEIDI DEITZER (CBD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:DEITZER
Last Name:MILLS
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-2214
Mailing Address - Country:US
Mailing Address - Phone:570-406-8897
Mailing Address - Fax:
Practice Address - Street 1:8211 KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-2214
Practice Address - Country:US
Practice Address - Phone:570-406-8897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula