Basic Information
| Provider Information | |||||||||
| NPI: | 1104240274 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLS | ||||||||
| FirstName: | RESHATA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 41114 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200180514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023634451 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4 ATLANTIC ST SW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200322350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025409857 | ||||||||
| FaxNumber: | 2022328494 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2014 | ||||||||
| LastUpdateDate: | 05/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | N | Other Service Providers | Midwife | 363L00000X | 0024171342 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | RN1027098 | DC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 176B00000X | RN1027098 | DC | Y | Other Service Providers | Midwife | 363L00000X | R219629 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.