Provider Demographics
NPI:1376582247
Name:MILLS, CARLA (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 9TH ST N STE 310
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5889
Mailing Address - Country:US
Mailing Address - Phone:239-285-3525
Mailing Address - Fax:239-775-9780
Practice Address - Street 1:311 9TH ST N
Practice Address - Street 2:SUITE 310
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5885
Practice Address - Country:US
Practice Address - Phone:239-261-9990
Practice Address - Fax:239-261-9993
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1996782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY060WOtherBLUE CROSS/BLUE SHIELD
FLE5069AMedicare ID - Type Unspecified
FLY060WOtherBLUE CROSS/BLUE SHIELD