IndividualActive
Airneida Bumgardner-Miles
NPI 1639879455 · Optician · Oak Grove, KY
Provider details
- NPI number
- 1639879455
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 111731 (KY)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
14800 Fort Campbell Blvd
Oak Grove, KY 42262-8304
Phone: (270) 640-4828
Approximate (ZIP-level) locationGet directions
Mailing address
14800 Fort Campbell Blvd
Oak Grove, KY 42262-8304
Registry dates
- Enumerated
- 2023-03-09
- Last updated
- 2023-03-09
- Certified
- 2023-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.