Individual
JERRY MILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(513) 470-0014
Mailing address
411 DULLES DR APT 3213, LAFAYETTE, LA 70506-3082
(513) 470-0014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1137580
KY
163W00000X
Registered Nurse
395678
OH
163W00000X
Registered Nurse
Primary
RN150263
LA
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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