Individual
BLAKE HENRY MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
977 S VIA LA COSTA WAY, KAYSVILLE, UT 84037-2839
(801) 589-6988
Mailing address
977 S VIA LA COSTA WAY, KAYSVILLE, UT 84037-2839
(801) 589-6988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5808074-4405
UT
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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