Provider Demographics
NPI:1770173205
Name:MILLS, MARGARET J (FNP-C)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:J
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 1:805 S BOND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3307
Mailing Address - Country:US
Mailing Address - Phone:720-480-2052
Mailing Address - Fax:
Practice Address - Street 1:555 BRYANT ST STE 814
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1704
Practice Address - Country:US
Practice Address - Phone:415-663-5584
Practice Address - Fax:844-640-3975
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1770173205Medicaid