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NPI Code Detail

MEDICARE: PEYTON ROCK

MEDICARE: PEYTON ROCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAPRN-NP278647GA
2363L00000XNurse PractitionerAPRN-NP278647GA

General Provider Information

NPI Number : 1043184351
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEYTON ROCK
Provider Business Mailing Address
First Line : PO BOX 71801
Second Line :
City : NEWNAN
State : GA
Zip : 30271-1801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1255 HIGHWAY 54 W
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-4526
Country : US
Telephone Number : 770-719-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2025
Last Update Date : 03/24/2026

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Directions to “ PEYTON ROCK ” Practice Location

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