Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 903589 | MS |
NPI | 1205487238 |
---|---|
Provider Name | Mrs. Ashley Harper Miles |
First Address | Laurel, MS 39443-9134 |
Second Address | Hattiesburg, MS 39401-7200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2019 |
Last Update Date | 20/09/2019 |