Provider Demographics
NPI:1912664475
Name:MILLS, MARIAH (FNP)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 QUIET RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7512
Mailing Address - Country:US
Mailing Address - Phone:443-366-1848
Mailing Address - Fax:
Practice Address - Street 1:203 QUIET RIDGE CT
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-7512
Practice Address - Country:US
Practice Address - Phone:443-366-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223419163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency