Provider Demographics
NPI:1013722412
Name:MILLS, SHARON MARIE (NP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:MILLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SOPERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30457-2631
Mailing Address - Country:US
Mailing Address - Phone:478-290-5103
Mailing Address - Fax:
Practice Address - Street 1:2825 BRECKINRIDGE BLVD STE 160
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-7601
Practice Address - Country:US
Practice Address - Phone:678-400-3600
Practice Address - Fax:678-400-3603
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218316163WH1000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice