MEDICARE: MRS. JENNIFER L MILES ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP2751132	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00282701	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Y057V	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609960459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER L MILES ARNP

Provider Business Mailing Address
First Line	:	1775 ONE HEALING PL
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4600
Country	:	US
Telephone Number	:	850-431-5360
Fax Number	:	850-431-5367

Provider Business Practice Location Address
First Line	:	1775 ONE HEALING PL
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4600
Country	:	US
Telephone Number	:	850-431-5360
Fax Number	:	850-431-5367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/16/2016

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