Individual
CHERYL L MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP441A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP441A
STATE LICENSE #
ID
Enumeration date
07/02/2006
Last updated
09/11/2012
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