Individual
RANDI MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3407 AIRPORT WAY, FAIRBANKS, AK 99709-4761
(907) 456-4524
Mailing address
3407 AIRPORT WAY, FAIRBANKS, AK 99709-4761
(907) 456-4524
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
01/04/2012
Last updated
07/10/2013
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