Provider Demographics
NPI:1932279569
Name:MILES, JUDY (NP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROCHESTER HILL RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1709
Mailing Address - Country:US
Mailing Address - Phone:603-335-2401
Mailing Address - Fax:603-335-2420
Practice Address - Street 1:245 ROCHESTER HILL RD STE 1A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1709
Practice Address - Country:US
Practice Address - Phone:603-335-2401
Practice Address - Fax:864-366-0818
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3744363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3255Medicare PIN