Provider Demographics
NPI:1568287233
Name:MILLS, KIMBERLY FRANCHELLE (RN)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:FRANCHELLE
Last Name:MILLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9532 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-3006
Mailing Address - Country:US
Mailing Address - Phone:310-529-3519
Mailing Address - Fax:
Practice Address - Street 1:9532 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-3006
Practice Address - Country:US
Practice Address - Phone:310-529-3519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA816187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse