Provider Demographics
NPI:1790189231
Name:MILLS, ELIZABETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 LOS ALTOS DR
Mailing Address - Street 2:
Mailing Address - City:PEBBLE BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93953-3014
Mailing Address - Country:US
Mailing Address - Phone:707-494-0070
Mailing Address - Fax:
Practice Address - Street 1:2511 GARDEN RD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5330
Practice Address - Country:US
Practice Address - Phone:831-373-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310314363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily