Provider Demographics
NPI:1255952719
Name:MPRAH, ALICE MILLS
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:MILLS
Last Name:MPRAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 JESSIE CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4747
Mailing Address - Country:US
Mailing Address - Phone:347-494-9159
Mailing Address - Fax:
Practice Address - Street 1:7200 JESSIE CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4747
Practice Address - Country:US
Practice Address - Phone:347-494-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX989193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse