Individual provider · Type 1 NPI
Ebunoluwa Mikie
Psychiatric/Mental Health Nurse Practitioner · Griffin, GA
NPI number
1124669403
Active
Practice location
410 E Taylor St Ste K2
Griffin, GA 30223-3444
Fax (770) 796-7726
Mailing address
164 Al Jennah Blvd
Locust Grove, GA 30248-3753
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | RN230157 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1124669403
Ebunoluwa Mikie's National Provider Identifier is 1124669403, issued on Oct 8, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Griffin, GA. The record was last updated on Oct 3, 2026.