Provider Demographics
NPI:1023846524
Name:MILES, MICHELLE RENEE (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
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:DHB MEDICAL MANAGEMENT
Mailing Address - Street 2:2080 CHILD ST
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259
Mailing Address - Country:US
Mailing Address - Phone:904-542-9682
Mailing Address - Fax:888-410-0935
Practice Address - Street 1:DHB MEDICAL MANAGEMENT
Practice Address - Street 2:2080 CHILD ST
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259
Practice Address - Country:US
Practice Address - Phone:904-542-9682
Practice Address - Fax:888-410-0935
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9411040163WC0400X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management