Provider Demographics
NPI:1326784497
Name:MILLS, LIA
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:
Last Name:MILLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 LANTANA DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8807
Mailing Address - Country:US
Mailing Address - Phone:302-763-3455
Mailing Address - Fax:
Practice Address - Street 1:304 LANTANA DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8807
Practice Address - Country:US
Practice Address - Phone:302-763-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN82114163W00000X
DEL1-0074986163W00000X
NV853458363LF0000X
DELG-0013099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse