Provider Demographics
NPI:1124243464
Name:GILES, LANA AMELIA (CNM)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:AMELIA
Last Name:GILES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 COCKRILL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2413
Mailing Address - Country:US
Mailing Address - Phone:972-548-9067
Mailing Address - Fax:
Practice Address - Street 1:406 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2714
Practice Address - Country:US
Practice Address - Phone:214-495-9911
Practice Address - Fax:214-495-9918
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628750367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife