Individual
EBUNOLUWA MIKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 E BROAD ST STE 109B, GRIFFIN, GA 30223-3351
(770) 678-0038
(770) 796-7726
Mailing address
324 E BROAD ST STE 109B, GRIFFIN, GA 30223-3351
(770) 678-0038
(770) 796-7726
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN230157
GA
Other
Enumeration date
10/08/2019
Last updated
09/28/2025
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