Provider Demographics
NPI:1518456540
Name:MILLS, VANESSA LU (LPN)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:LU
Last Name:MILLS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 NW 27TH AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-7220
Mailing Address - Country:US
Mailing Address - Phone:305-835-0101
Mailing Address - Fax:305-835-0102
Practice Address - Street 1:6600 NW 27TH AVE STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-7220
Practice Address - Country:US
Practice Address - Phone:305-835-0101
Practice Address - Fax:305-835-0102
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL814161164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse