Provider Demographics
NPI:1881223238
Name:MILLS, CRYSTEL (RN,CBIS)
Entity Type:Individual
Prefix:
First Name:CRYSTEL
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:RN,CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 VILLA CREEK DR STE 140
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7385
Mailing Address - Country:US
Mailing Address - Phone:214-738-9279
Mailing Address - Fax:
Practice Address - Street 1:2655 VILLA CREEK DR STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7385
Practice Address - Country:US
Practice Address - Phone:214-738-9279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708976163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation