Provider Demographics
NPI:1598873697
Name:MILEY, KIM PAULETTE (DC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:PAULETTE
Last Name:MILEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13095 S MUR LEN RD
Mailing Address - Street 2:STE 170
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1250
Mailing Address - Country:US
Mailing Address - Phone:913-393-2611
Mailing Address - Fax:913-393-3729
Practice Address - Street 1:13095 S MUR LEN RD
Practice Address - Street 2:STE 170
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1250
Practice Address - Country:US
Practice Address - Phone:913-393-2611
Practice Address - Fax:913-393-3729
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS29234016OtherBCBS OF KANSAS CITY
KS29234016OtherBCBS OF KANSAS CITY