Provider Demographics
NPI:1518655372
Name:MILES, CLARENITH (RN)
Entity Type:Individual
Prefix:
First Name:CLARENITH
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CHATTUCK CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-3622
Mailing Address - Country:US
Mailing Address - Phone:443-622-1064
Mailing Address - Fax:
Practice Address - Street 1:17 CHATTUCK CT
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-3622
Practice Address - Country:US
Practice Address - Phone:443-622-1064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9628015163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health