Provider Demographics
NPI:1568619278
Name:MILLS, BETHANNE (LNP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANNE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:LNP
Other - Prefix:MISS
Other - First Name:BETHANNE
Other - Middle Name:
Other - Last Name:HOGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:9 LISZAR DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1252
Mailing Address - Country:US
Mailing Address - Phone:703-785-0025
Mailing Address - Fax:
Practice Address - Street 1:9 LISZAR DR
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1252
Practice Address - Country:US
Practice Address - Phone:703-785-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167893363LP2300X
DEL1-0043357163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care