Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2002018384 | MO |
NPI | 1033146949 |
---|---|
Provider Name | Shynda F Miles |
First Address | Leawood, KS 66206-1553 |
Second Address | Leawood, KS 66206-1553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 06/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205898901 | (05) | MO |
H69871 | (02) |