Provider Demographics
NPI:1568171643
Name:MILLS, ERNEST DANIEL (APRN)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:DANIEL
Last Name:MILLS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:DANNY
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:722 W BYERS AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-6330
Mailing Address - Country:US
Mailing Address - Phone:270-478-5040
Mailing Address - Fax:270-478-5034
Practice Address - Street 1:722 W BYERS AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-6330
Practice Address - Country:US
Practice Address - Phone:270-478-5040
Practice Address - Fax:270-478-5034
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine