Individual provider · Type 1 NPI
Nicole Susann Miles, NP
Pediatric Nurse Practitioner · Grand Rapids, MI
NPI number
1497563548
Active
Practice location
300 68th St SE
Grand Rapids, MI 49548-6927
Mailing address
100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 4704323923 (MI) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 4704323923 (MI) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1497563548
Nicole Susann Miles, NP's National Provider Identifier is 1497563548, issued on Dec 20, 2024. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Grand Rapids, MI. The record was last updated on Jan 5, 2026.