Provider Demographics
NPI:1215621149
Name:MILES, ROSLIND L (LD, PPD)
Entity type:Individual
Prefix:
First Name:ROSLIND
Middle Name:L
Last Name:MILES
Suffix:
Gender:F
Credentials:LD, PPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3929
Mailing Address - Country:US
Mailing Address - Phone:916-717-3106
Mailing Address - Fax:
Practice Address - Street 1:1616 PARK BLVD
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3929
Practice Address - Country:US
Practice Address - Phone:916-717-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula