Provider Demographics
NPI:1841974235
Name:MILLS, LISA (HHC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:HHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 491
Mailing Address - Street 2:
Mailing Address - City:WAKARUSA
Mailing Address - State:IN
Mailing Address - Zip Code:46573-0491
Mailing Address - Country:US
Mailing Address - Phone:574-370-0988
Mailing Address - Fax:
Practice Address - Street 1:64881 COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:WAKARUSA
Practice Address - State:IN
Practice Address - Zip Code:46573
Practice Address - Country:US
Practice Address - Phone:574-370-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach