Healthcare Provider Details

I. General information

NPI: 1760610844
Provider Name (Legal Business Name): LINDSAY KRISTINE MILES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDSAY KRISTINE GOVERT

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7106 SOUTH AVE
MIDDLETON WI
53562-3299
US

IV. Provider business mailing address

4418 YUMA DR
MADISON WI
53711-2808
US

V. Phone/Fax

Practice location:
  • Phone: 608-829-9389
  • Fax:
Mailing address:
  • Phone: 608-520-0531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3253-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: