Provider Demographics
NPI:1306651153
Name:MILES, KHALILAH YVONNE (DOULA)
Entity type:Individual
Prefix:MRS
First Name:KHALILAH
Middle Name:YVONNE
Last Name:MILES
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3974 IVANREST AVE SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2032
Mailing Address - Country:US
Mailing Address - Phone:616-919-4900
Mailing Address - Fax:
Practice Address - Street 1:3974 IVANREST AVE SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2032
Practice Address - Country:US
Practice Address - Phone:616-919-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula