Provider Demographics
NPI:1881102770
Name:MYLES, PRISCILLA
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:
Last Name:MYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4987 PINTAIL CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-9506
Mailing Address - Country:US
Mailing Address - Phone:240-815-1809
Mailing Address - Fax:
Practice Address - Street 1:4987 PINTAIL CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-9506
Practice Address - Country:US
Practice Address - Phone:240-815-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-13
Last Update Date:2018-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health