| Doctor Name: | THERESA K MILEY |
| NPI Number: | 1184693129 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.R.N.P. |
| License Number: | R145616 |
| Business Practice Address: | 5009 Honeygo Center Dr Perry Hall, MD - 211289828 |
| Business Phone Number: | 4437252120 |
| Business Fax Number: | |
| Mailing Address: | 3831 Roland Ave, BALTIMORE |
| State: | MD |
| Postal Code: | 212112040 |
| Phone Number: | 4436212124 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2006 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | R145616 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |