MEDICARE: JUDY MILES NP

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	363LF0000X	Family Nurse Practitioner	3744	SC

General Provider Information

NPI Number	:	1932279569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY MILES NP

Provider Business Mailing Address
First Line	:	245 ROCHESTER HILL RD STE 1A
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-1709
Country	:	US
Telephone Number	:	603-335-2401
Fax Number	:	603-335-2420

Provider Business Practice Location Address
First Line	:	245 ROCHESTER HILL RD STE 1A
Second Line	:
City	:	ROCHESTER
State	:	NH
Zip	:	03867-1709
Country	:	US
Telephone Number	:	603-335-2401
Fax Number	:	864-366-0818

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

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	02/13/2020

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