Healthcare Provider Details

I. General information

NPI: 1811859515
Provider Name (Legal Business Name): LEANNA MARIE MILES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 SAWYER HOLW
PINEVILLE AR
72566-6000
US

IV. Provider business mailing address

485 SAWYER HOLW
PINEVILLE AR
72566-6000
US

V. Phone/Fax

Practice location:
  • Phone: 870-916-8362
  • Fax:
Mailing address:
  • Phone: 870-916-8362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number202500016
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: