Darla Miles, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Windom, MN
NPI 1457729402 · NPPES record last updated Jun 8, 2020
Key facts
- NPI
- 1457729402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 230393-8 (MN)
- Practice address
- 591 2ND Ave N
Windom, MN 56101-1927 - Phone
- (419) 973-4820
- NPI assigned
- Sep 8, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MN, OH, MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151103001243 | MN | Practitioner - Nurse Practitioner | 0446560429 | Reassigns benefits to 2 organizations |
| I20170714001913 | OH | Practitioner - Nurse Practitioner | 0446560429 | Reassigns benefits to 2 organizations |
| I20230522000422 | MI | Practitioner - Nurse Practitioner | 0446560429 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 230393-8 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CCM Health | Current |
Accepting new patients | |
| CCM Health | Current |
Accepting new patients | |
| Development Centers, Inc. | Current |
Accepting new patients | |
| Mercy Medical Partners Northern Region LLC | Current |
Accepting new patients | |
| Djmnp LLC | Psychiatric/Mental Health | Current | Accepting new patients |
| Mercy Medical Partners Northern Region LLC | Current |
Accepting new patients |
Locations
17421 Telegraph Rd
Detroit, MI 48219
Phone (313) 255-0900
24424 W McNichols Rd
Detroit, MI 48219
Phone (313) 255-0900
17141 Ryan Rd
Hamtramck, MI 48212
Phone (313) 369-1717
4321 E McNichols Rd
Hamtramck, MI 48212
Phone (313) 334-6717
824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877
400 E 1st St
Morris, MN 56267
Phone (320) 589-1313
1400 E 2nd St
Defiance, OH 43512
Phone (419) 784-1414
3130 Executive Pkwy
Fl 8
Toledo, OH 43606
Phone (419) 720-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 230393-8 | MN | Yes |
Addresses
Primary practice location
591 2ND Ave N
Windom, MN 56101-1927
Mailing address
3101 Estuary PL
Maumee, OH 43537-9437
Phone (419) 973-4820
Other practice location 1
301 Becker Ave SW
Willmar, MN 56201-3302
Phone (320) 235-4543
Other providers in Windom, MN
- Bruce William Larkin
- Tracy Leysen
- Claudia Lopez
- Joel Luitjens
- Alyson Jean Malchow
- Brianne Miller
- James Day Miller
- Karrie Riley Myers
- G P Nelson
- New Song Music Therapy LLC
All providers in Windom, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.