Individual
MS. BRENDA MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHN
Contact information
Practice address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(603) 552-5203
(605) 355-2530
Mailing address
3200 CANYON LAKE DR, RAPID CITY, SD 57702-8114
(603) 552-5203
(605) 355-2530
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R021724
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140070
—
SD
05
—
5549050
—
SD
Enumeration date
05/08/2009
Last updated
05/08/2009
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