Basic Information
| Provider Information | |||||||||
| NPI: | 1265802284 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILES | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | PA-C | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JEROME | ||||||||
| OtherFirstName: | RACHEL | ||||||||
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| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 12200 W 106TH ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662152305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135415500 | ||||||||
| FaxNumber: | 9135417474 | ||||||||
| Practice Location | |||||||||
| Address1: | 8919 PARALLEL PKWY | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661121636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137887111 | ||||||||
| FaxNumber: | 9137883702 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2015 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1501845 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.