Provider Demographics
NPI:1326823493
Name:MILES, BRITTANY NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:MILES
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:1461 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7751
Practice Address - Country:US
Practice Address - Phone:502-446-5555
Practice Address - Fax:502-584-5889
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4009030363LF0000X
IN71014250A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4009030OtherKY STATE LICENSE
KY7100934430Medicaid
IN71014250AOtherINDIANA STATE LICENSE
IN300082258Medicaid