Provider Demographics
NPI:1447854187
Name:MILLS, TAMMY ANN
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:ANN
Last Name:MILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12608 INDIAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CLEAR SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:21722-1307
Mailing Address - Country:US
Mailing Address - Phone:240-527-1622
Mailing Address - Fax:
Practice Address - Street 1:118 E OAK RIDGE DR STE 2000
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-7890
Practice Address - Country:US
Practice Address - Phone:301-582-8563
Practice Address - Fax:240-536-9118
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD246RP1900X
MD289468246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty