MEDICARE: CAPRICE MILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN17592	NV

General Provider Information

NPI Number	:	1780454272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAPRICE MILES

Provider Business Mailing Address
First Line	:	4985 BIRCHLAND MANOR AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7596
Country	:	US
Telephone Number	:	708-491-9833
Fax Number	:

Provider Business Practice Location Address
First Line	:	6031 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-4200
Country	:	US
Telephone Number	:	708-491-9833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	01/05/2024

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Directions to “ CAPRICE MILES ” Practice Location

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