Provider Demographics
NPI:1023272978
Name:MILLS, ELIZABETH SILVA (LVN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SILVA
Last Name:MILLS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32840 PRESIDIO HILLS LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8283
Mailing Address - Country:US
Mailing Address - Phone:951-454-2608
Mailing Address - Fax:
Practice Address - Street 1:36425 COGNAC ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-9109
Practice Address - Country:US
Practice Address - Phone:951-454-2608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN182187164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse