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

LicenseStateTypeSpecialty
R6C41MOMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Saint Ann, MO

All providers in Saint Ann, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.