Individual
JACK J MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-2000
Mailing address
1441 U ST NW APT 708, WASHINGTON, DC 20009-3530
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2276965
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN1026396
DC
Other
Enumeration date
06/09/2017
Last updated
07/03/2019
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