Provider Demographics
NPI:1609000926
Name:MILLS, NANCY SUZANNE (CST/CFA)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SUZANNE
Last Name:MILLS
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 OLD BULLARD RD
Mailing Address - Street 2:APT 176
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-4326
Mailing Address - Country:US
Mailing Address - Phone:903-571-8218
Mailing Address - Fax:
Practice Address - Street 1:5621 OLD BULLARD RD
Practice Address - Street 2:APT 176
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-4326
Practice Address - Country:US
Practice Address - Phone:903-571-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant