Provider Demographics
NPI:1528803244
Name:MILLS, JASMINE BREAIL
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:BREAIL
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 GREENUP AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7659
Mailing Address - Country:US
Mailing Address - Phone:606-618-7785
Mailing Address - Fax:
Practice Address - Street 1:1625 GREENUP AVE STE 1
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7659
Practice Address - Country:US
Practice Address - Phone:606-618-7785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator