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General NPI Number Information
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NPI Number | 1043868367
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Entity Type | Individual
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Provider Name | C. SUNFLOWER MILES RN
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 741 N COLONYSURF DR
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City | LILLIWAUP
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State | WA
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Zip | 98555-9855
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Country | US
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Telephone | 253-261-6961
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Fax |
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Provider Business Mailing Address
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Address Line | 741 N COLONY SURF DR
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City | LILLIWAUP
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State | WA
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Zip | 98555-9782
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Country | US
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Telephone | 253-261-6961
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 60434991
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN612122141
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License Number State | WA
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