Provider Demographics
NPI:1861620999
Name:MILLS, ERIN MICHELE (OD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MICHELE
Last Name:MILLS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15005-206 GRAND SUMMIT BLVD
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030
Mailing Address - Country:US
Mailing Address - Phone:785-691-7757
Mailing Address - Fax:
Practice Address - Street 1:19040 E VALLEY VIEW PARKWAY
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-200-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009016952152W00000X
KS1853152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist