Individual
CAROL ANN MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
6146 COTTONTAIL RD NE, RIO RANCHO, NM 87144-1543
(505) 249-0996
Mailing address
6146 COTTONTAIL RD NE, RIO RANCHO, NM 87144-1543
(505) 249-0996
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
255
AK
363LF0000X
Family Nurse Practitioner
Primary
R14155
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
255
NURSE PRACTITIONER LICENSE
AK
01
—
80456880
MEDICAID NEW MEXICO
—
01
—
R14155
NURSING LICENSE
NM
Enumeration date
02/28/2006
Last updated
03/07/2023
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