Provider Demographics
NPI:1841323912
Name:MILLS, MARTHA (CNM)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 LAUREL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3012
Mailing Address - Country:US
Mailing Address - Phone:404-321-5910
Mailing Address - Fax:404-508-5560
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:SUITE 512
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-508-2000
Practice Address - Fax:404-508-5560
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN098685367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife