Healthcare Provider Details

I. General information

NPI: 1275975740
Provider Name (Legal Business Name): JOHN MICHAEL MILBURN II C.N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date: 08/04/2016
Reactivation Date: 11/28/2016

III. Provider practice location address

501 GREAT CIRCLE RD FL 3
NASHVILLE TN
37228-1317
US

IV. Provider business mailing address

501 GREAT CIRCLE RD # FI3
NASHVILLE TN
37228-1317
US

V. Phone/Fax

Practice location:
  • Phone: 615-436-9060
  • Fax: 615-235-9725
Mailing address:
  • Phone: 615-436-9060
  • Fax: 615-235-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.15213
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.341255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: