Provider Demographics
NPI:1407333784
Name:MILLS, BRITTNY NICOLE (AGPCNP-C)
Entity Type:Individual
Prefix:MS
First Name:BRITTNY
Middle Name:NICOLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-6711
Mailing Address - Country:US
Mailing Address - Phone:903-824-0582
Mailing Address - Fax:
Practice Address - Street 1:3401 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-6711
Practice Address - Country:US
Practice Address - Phone:903-824-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner