Healthcare Provider Details

I. General information

NPI: 1629990379
Provider Name (Legal Business Name): PAYTON NICHOLE MILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAYTON PHILLIPS

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 FRANKLIN PKWY
FRANKLIN GA
30217-7508
US

IV. Provider business mailing address

99 ANTIOCH RD
FRANKLIN GA
30217-3601
US

V. Phone/Fax

Practice location:
  • Phone: 706-675-8669
  • Fax:
Mailing address:
  • Phone: 404-547-8057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP287387
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: