Provider Demographics
NPI:1205644341
Name:MILLS, ROSE SHARON
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:SHARON
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 WILLOWMOORE AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-2934
Mailing Address - Country:US
Mailing Address - Phone:336-689-7884
Mailing Address - Fax:
Practice Address - Street 1:4216 SACRAMENTO DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-6325
Practice Address - Country:US
Practice Address - Phone:336-689-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider