Provider Demographics
NPI:1164898425
Name:MILES, TIMIKKA
Entity Type:Individual
Prefix:
First Name:TIMIKKA
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5281 NOWATA RD APT 103
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-5759
Mailing Address - Country:US
Mailing Address - Phone:856-685-4779
Mailing Address - Fax:
Practice Address - Street 1:5281 NOWATA RD APT 103
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-5759
Practice Address - Country:US
Practice Address - Phone:856-685-4779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator