Provider Demographics
NPI:1912100330
Name:MILLS, DANA SABRINA (CRNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:SABRINA
Last Name:MILLS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-2562
Mailing Address - Country:US
Mailing Address - Phone:334-222-1551
Mailing Address - Fax:334-222-1577
Practice Address - Street 1:108 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-2562
Practice Address - Country:US
Practice Address - Phone:334-222-1551
Practice Address - Fax:334-222-1577
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-096348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51593634OtherBCBS ALABAMA
AL1912100330Medicaid
510I500319Medicare PIN