Individual
MARLA KRISTEN MIKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
101 HARRIS INDUSTRIAL BLVD STE A, VIDALIA, GA 30474-8852
(912) 535-3500
Mailing address
956 BURNELL GASKINS RD, WILLACOOCHEE, GA 31650-6136
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN275033
GA
Other
Enumeration date
10/19/2023
Last updated
11/06/2023
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