Healthcare Provider Details

I. General information

NPI: 1801586607
Provider Name (Legal Business Name): HAILEY MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13845 CONLAN CIR
CHARLOTTE NC
28277-2705
US

IV. Provider business mailing address

13845 CONLAN CIR
CHARLOTTE NC
28277-2705
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-14224
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: