Provider Demographics
NPI:1568524973
Name:MILLS, RUBY (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7475 WISCONSIN AVENUE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-986-8010
Mailing Address - Fax:
Practice Address - Street 1:7475 WISCONSIN AVE
Practice Address - Street 2:SUITE 350
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3412
Practice Address - Country:US
Practice Address - Phone:301-986-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR039536163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse