Individual
DENISE A MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3115 E FLORENCE DR, MERIDIAN, ID 83642-1586
(208) 895-8670
(208) 955-0494
Mailing address
3115 E FLORENCE DR, MERIDIAN, ID 83642-1586
(208) 895-8670
(208) 955-0494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M9421
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20849
MD LICENSE
AR
05
—
80736340004
—
ID
01
—
G69647
MD LICENSE
CA
Enumeration date
04/17/2006
Last updated
03/09/2010
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