Provider Demographics
NPI:1225800824
Name:MILES, FELICIA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:MICHELLE
Last Name:MILES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 SUNBURST TRL
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-5218
Mailing Address - Country:US
Mailing Address - Phone:972-877-8239
Mailing Address - Fax:
Practice Address - Street 1:7604 SUNBURST TRL
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-5218
Practice Address - Country:US
Practice Address - Phone:972-877-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA232510363LP2300X
TX1131815363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care