Provider Demographics
NPI:1215769674
Name:PICKARD, MILAIKA MICOLE (RN)
Entity type:Individual
Prefix:
First Name:MILAIKA
Middle Name:MICOLE
Last Name:PICKARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 BURRUS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3219
Mailing Address - Country:US
Mailing Address - Phone:762-822-9535
Mailing Address - Fax:
Practice Address - Street 1:1810 STADIUM DR STE 240
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3179
Practice Address - Country:US
Practice Address - Phone:334-297-4883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN271239163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse