Provider Demographics
NPI:1114759321
Name:MILES, EMILY (DNP, AGACNP-BC, CCRN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:DNP, AGACNP-BC, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-3128
Mailing Address - Country:US
Mailing Address - Phone:855-524-4001
Mailing Address - Fax:712-325-2499
Practice Address - Street 1:800 MERCY DR
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-3128
Practice Address - Country:US
Practice Address - Phone:855-524-4001
Practice Address - Fax:712-325-2499
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE83031163W00000X
NE115503363L00000X
IAH183734363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse