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

Mylene Lilian Gonzales

Individual provider Gerontology Nurse Practitioner · NPI 1396345948

Mylene Lilian Gonzales is a Nurse Practitioner in Johns Creek, Georgia. Qualified in 2022, 4 years ago. Practices with Elemental Living Inc, an 8-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2020
Specialties on file
2

Practice location Address checks out

4700 Ogeechee Dr
Johns Creek, GA 30022-1095
Phone: (770) 403-2186
Show map & directions

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

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence RN249672 (GA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence RN249672 (GA)

Record details

NPI number1396345948
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 31, 2020
Last updated in NPPESDecember 24, 2025
Certification dateDecember 24, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Elemental Living Inc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare