Individual
NICOLE SUSANN MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704323923
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
4704323923
MI
Other
Enumeration date
12/20/2024
Last updated
01/05/2026
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