Provider Demographics
NPI:1558640144
Name:MILLS, ALICE (FNP)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406C DALTON DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3103
Mailing Address - Country:US
Mailing Address - Phone:802-655-3394
Mailing Address - Fax:
Practice Address - Street 1:1127 NORTH AVE STE 41
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-2758
Practice Address - Country:US
Practice Address - Phone:802-846-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0079688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily