Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ebunoluwa Mikie

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1124669403

Ebunoluwa Mikie is a Nurse Practitioner in Griffin, Georgia. Qualified in 2023, 3 years ago. Offers telehealth. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2019

Practice location Address checks out

410 E Taylor St Ste K2
Griffin, GA 30223-3444
Phone: (770) 678-0038
Fax: (770) 796-7726
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN230157 (GA)

Record details

NPI number1124669403
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 8, 2019
Last updated in NPPESJuly 11, 2026
Certification dateJuly 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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