Individual
KESHIA LYNETTE MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8220 CASTOR AVE, PHILA, PA 19152-2729
(215) 919-3119
Mailing address
8220 CASTOR AVE, PHILA, PA 19152-2729
(215) 919-3119
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN309253
PA
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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