Miles Med Management Service Corporation
NPI #1225703705 in Saint Louis Park, Minnesota
Provider Information
- NPI Number
- 1225703705
- Entity Type
- Organization
- Organization Name
- Miles Med Management Service Corporation
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Aug 16, 2021
- Last Updated
- Sep 15, 2021
Practice Location
- Address
- 5775 WAYZATA BLVD STE 767
- City
- Saint Louis Park
- State
- Minnesota
- ZIP Code
- 55416-1222
- Phone
- (612) 708-7562
Authorized Official
- Name
- LISA ANN MILES, APNP
- Title
- NURSE PRACTITIONER
- Phone
- (612) 708-7562
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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