Provider Demographics
NPI:1912887357
Name:MILLS FAMILY PRACTICE LLC
Entity type:Organization
Organization Name:MILLS FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:KEARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-BC
Authorized Official - Phone:307-224-6078
Mailing Address - Street 1:12473 POISON SPIDER RD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-9551
Mailing Address - Country:US
Mailing Address - Phone:307-224-6078
Mailing Address - Fax:307-224-6099
Practice Address - Street 1:510 WYOMING BLVD SW
Practice Address - Street 2:
Practice Address - City:MILLS
Practice Address - State:WY
Practice Address - Zip Code:82644
Practice Address - Country:US
Practice Address - Phone:307-224-6078
Practice Address - Fax:307-224-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty