| Doctor Name: | KATINA SHERESE MILES |
| NPI Number: | 1225119753 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | RN135225 |
| Business Practice Address: | 7950 Martin Loop Fort Benning, GA - 319055648 |
| Business Phone Number: | 7065445176 |
| Business Fax Number: | 7065445202 |
| Mailing Address: | 1639 Bradley Park Dr, Pmb # 228 COLUMBUS |
| State: | GA |
| Postal Code: | 319043620 |
| Phone Number: | 7068888977 |
| Fax Number: | 3342971787 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 06/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN135225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |