Provider Demographics
NPI:1720304546
Name:MILLS, YVONNE ELAINE (LICENSED PRACTICAL N)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:ELAINE
Last Name:MILLS
Suffix:
Gender:F
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KANE AVE. BLD. D-5
Mailing Address - Street 2:YVONNE E. MILLS
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1419
Mailing Address - Country:US
Mailing Address - Phone:315-406-4429
Mailing Address - Fax:
Practice Address - Street 1:10 KANE AVE. BLD. D-5
Practice Address - Street 2:YVONNE E. MILLS
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-1419
Practice Address - Country:US
Practice Address - Phone:315-406-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209506-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse