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Individual

MRS. KIA DELEASE MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
260 TROTTERS WALK, COVINGTON, GA 30016-8115
(210) 294-1918
Mailing address
260 TROTTERS WALK, COVINGTON, GA 30016-8115
(210) 294-1918

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
816877
TX
363LF0000X
Family Nurse Practitioner
Primary
RN188118
GA

Other

Enumeration date
11/22/2010
Last updated
05/07/2012
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