Provider Demographics
NPI:1386444602
Name:MILES, LAURA (RN IBCLC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MILES
Suffix:
Gender:
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SPRUCE TREE LN UNIT 22
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1037
Mailing Address - Country:US
Mailing Address - Phone:774-286-1982
Mailing Address - Fax:774-286-1982
Practice Address - Street 1:7 SPRUCE TREE LN UNIT 22
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1037
Practice Address - Country:US
Practice Address - Phone:774-286-1982
Practice Address - Fax:774-286-1982
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-301510163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant