Provider Demographics
NPI:1508394305
Name:MILES, KATHERINE ANNE (CD, SBD, CYBE, ISE)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNE
Last Name:MILES
Suffix:
Gender:F
Credentials:CD, SBD, CYBE, ISE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S MARY ETTA ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2225
Mailing Address - Country:US
Mailing Address - Phone:316-992-3901
Mailing Address - Fax:
Practice Address - Street 1:212 S MARY ETTA ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2225
Practice Address - Country:US
Practice Address - Phone:316-992-3901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-24
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator