Provider Demographics
NPI:1578858304
Name:MILLS, TALITHA D (CPM)
Entity Type:Individual
Prefix:
First Name:TALITHA
Middle Name:D
Last Name:MILLS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 CHIPMAN RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37022-8645
Mailing Address - Country:US
Mailing Address - Phone:615-841-3070
Mailing Address - Fax:615-841-3234
Practice Address - Street 1:502 CHIPMAN RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:TN
Practice Address - Zip Code:37022-8645
Practice Address - Country:US
Practice Address - Phone:615-841-3070
Practice Address - Fax:615-841-3234
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000048176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife