Provider Demographics
NPI:1235653908
Name:MILEY, AMANDA J (CNS)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:J
Last Name:MILEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:J
Other - Last Name:BLANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:PO BOX 3407
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47733-3407
Mailing Address - Country:US
Mailing Address - Phone:812-450-7700
Mailing Address - Fax:812-450-7705
Practice Address - Street 1:350 W COLUMBIA ST STE 350
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-5610
Practice Address - Country:US
Practice Address - Phone:812-450-7700
Practice Address - Fax:812-450-7705
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016827364S00000X
IN71007466A364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist