Provider Demographics
NPI:1831075837
Name:MILLS, SUSANNA WHITTEN (DNP, FNP-C, BSN, RN)
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:WHITTEN
Last Name:MILLS
Suffix:
Gender:F
Credentials:DNP, FNP-C, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:855 JESSIS MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WEST BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84087-1946
Mailing Address - Country:US
Mailing Address - Phone:210-563-6459
Mailing Address - Fax:210-563-6459
Practice Address - Street 1:855 JESSIS MEADOW DR
Practice Address - Street 2:
Practice Address - City:WEST BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84087-1946
Practice Address - Country:US
Practice Address - Phone:210-563-6459
Practice Address - Fax:210-563-6459
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT11843852-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily