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General NPI Number Information
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NPI Number | 1033918628
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Entity Type | Individual
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Provider Name | TIFFANY JANELLE MILES FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1046 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27405-6712
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Country | US
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Telephone | 336-272-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 5502 BENTWOOD DR
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City | MC LEANSVILLE
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State | NC
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Zip | 27301-9797
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Country | US
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Telephone | 336-327-5120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021789
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License Number State | NC
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