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Individual

BENJAMIN J MILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1510 WOODHAVEN DR, SEVIERVILLE, TN 37862-6049
(865) 654-4600
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3620

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN47688
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3029155
BLUE CROSS BLUE SHIELD
TN
05
3600153
TN
Enumeration date
10/24/2005
Last updated
06/11/2020
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