Individual
MS. LORI JANE MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3151 E CENTER STREET EXT, WARSAW, IN 46582-3901
(574) 267-3070
(574) 267-4813
Mailing address
9712 N 300 W, HUNTINGTON, IN 46750-9726
(260) 344-3435
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000419A
STATE LICENSE NUMBER
IN
01
—
10000419B
CSR #
IN
Enumeration date
07/04/2006
Last updated
05/19/2010
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