Provider Demographics
NPI:1164172292
Name:MILES, ANNA KATHLEEN (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHLEEN
Last Name:MILES
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 BRIGHTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2383
Mailing Address - Country:US
Mailing Address - Phone:262-498-9498
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-257-1000
Practice Address - Fax:859-257-3347
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017513363LF0000X
KY1169778163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse