Provider Demographics
NPI:1578368692
Name:MILES, TARA ASHLEY MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:TARA ASHLEY
Middle Name:MICHELLE
Last Name:MILES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TARA ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:FELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:KANSAS CITY VA
Mailing Address - Street 2:4801 LINWOOD BLVD
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:
Practice Address - Street 1:KANSAS CITY VA
Practice Address - Street 2:4801 LINWOOD BLVD
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0122071163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse