Provider Demographics
NPI:1386392355
Name:MILES, ALISHA PATRICE (NP)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:PATRICE
Last Name:MILES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13733 N PRASADA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-8014
Mailing Address - Country:US
Mailing Address - Phone:623-444-7100
Mailing Address - Fax:
Practice Address - Street 1:13733 N PRASADA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-8014
Practice Address - Country:US
Practice Address - Phone:623-444-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ239755363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner