Provider Demographics
NPI:1821797457
Name:MILLS, SKYLEE ANN (PBT)
Entity Type:Individual
Prefix:
First Name:SKYLEE
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 N HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-5206
Mailing Address - Country:US
Mailing Address - Phone:405-214-4700
Mailing Address - Fax:405-878-1126
Practice Address - Street 1:1336 N HARRISON AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-5206
Practice Address - Country:US
Practice Address - Phone:405-214-4700
Practice Address - Fax:405-878-1126
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other