Brenda Mills
Individual provider Active NPI Family Medicine Physician · Saint Ann, MO
NPI 1306331855 · NPPES record last updated Jun 27, 2018
Key facts
- NPI
- 1306331855
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R6C41 (MO)
- Practice address
- 10814 Saint Charles Rock Rd
Saint Ann, MO 63074-1508 - Phone
- (314) 401-2402
- NPI assigned
- Jun 27, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R6C41 | MO | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R6C41 | MO | Yes |
Addresses
Primary practice location
10814 Saint Charles Rock Rd
Saint Ann, MO 63074-1508
Mailing address
10814 Saint Charles Rock Rd
Saint Ann, MO 63074-1508
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All providers in Saint Ann, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.