Provider Demographics
NPI:1679971600
Name:MILLS, KIMBERLY NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:NICOLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731263
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1263
Mailing Address - Country:US
Mailing Address - Phone:214-884-4700
Mailing Address - Fax:214-884-4761
Practice Address - Street 1:5421 THE STATION BLVD
Practice Address - Street 2:SUITE B2
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048
Practice Address - Country:US
Practice Address - Phone:469-649-9495
Practice Address - Fax:469-649-9744
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily