Provider Demographics
NPI:1912616574
Name:MILES, NATALIE NOELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:NOELLE
Last Name:MILES
Suffix:
Gender:F
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 1:698 MULLICA HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-4453
Mailing Address - Country:US
Mailing Address - Phone:856-508-3575
Mailing Address - Fax:856-221-4101
Practice Address - Street 1:698 MULLICA HILL RD STE 300
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-4453
Practice Address - Country:US
Practice Address - Phone:856-508-3575
Practice Address - Fax:856-221-4101
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-22
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01398800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty