Provider Demographics
NPI:1386268241
Name:MILLS, VERNON ROBERT JR
Entity type:Individual
Prefix:MR
First Name:VERNON
Middle Name:ROBERT
Last Name:MILLS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5019 36TH PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3909
Mailing Address - Country:US
Mailing Address - Phone:202-812-8364
Mailing Address - Fax:
Practice Address - Street 1:3101 CHANNING ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1514
Practice Address - Country:US
Practice Address - Phone:202-617-6657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant