Individual
BRADLEY ALAN MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
709 HOLLYBROOK DR STE 3400, LONGVIEW, TX 75605-2412
(903) 757-4691
Mailing address
709 HOLLYBROOK DR STE 3400, LONGVIEW, TX 75605-2412
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1170323
TX
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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