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NPI Code Detail

MEDICARE: DEIRDRA MILES

MEDICARE: DEIRDRA 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
1101Y00000XCounselor1234LA
2171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881116283
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEIRDRA MILES
Provider Business Mailing Address
First Line : 415 COURT ST
Second Line :
City : PORT ALLEN
State : LA
Zip : 70767-2747
Country : US
Telephone Number : 225-245-9070
Fax Number : 225-245-9073
Provider Business Practice Location Address
First Line : 415 COURT ST
Second Line :
City : PORT ALLEN
State : LA
Zip : 70767-2747
Country : US
Telephone Number : 225-245-9070
Fax Number : 225-245-9073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2017
Last Update Date : 07/21/2022

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Directions to “ DEIRDRA MILES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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