Provider Demographics
NPI:1063303519
Name:MILLS, BRIAN KEITH II
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KEITH
Last Name:MILLS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2567 MILVERTON WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-1763
Mailing Address - Country:US
Mailing Address - Phone:614-377-0035
Mailing Address - Fax:
Practice Address - Street 1:617 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2724
Practice Address - Country:US
Practice Address - Phone:614-446-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide