Healthcare Provider Details

I. General information

NPI: 1902519853
Provider Name (Legal Business Name): LAUREN MILES DNP-A, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 HARRY HINES BLVD
DALLAS TX
75235-7708
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-2118
  • Fax:
Mailing address:
  • Phone: 214-645-0624
  • Fax: 214-645-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1108220
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: