Individual
HOLLY NICOLE MYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3806 AMELIA AVE STE 2, LAFAYETTE, IN 47905-5772
(765) 449-3900
(765) 449-3901
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002110A
IN
363LA2100X
Acute Care Nurse Practitioner
71002110A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000668422
ANTHEM PROVIDER NUMBER
IN
05
—
200844660
—
IN
Enumeration date
07/02/2006
Last updated
03/13/2026
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