Provider Demographics
NPI:1851602536
Name:MILLS, KRISTIN T (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:T
Last Name:MILLS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 RAYWOOD VW APT 621
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7757
Mailing Address - Country:US
Mailing Address - Phone:240-810-2850
Mailing Address - Fax:
Practice Address - Street 1:WELLSPACE HEALTH J STREET COMMUNITY HEALTH CENTER
Practice Address - Street 2:1820 J STREET
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811
Practice Address - Country:US
Practice Address - Phone:916-737-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20170207RI0200X
CODR.0061815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine