Provider Demographics
NPI:1285341701
Name:LICHKAY, SKYLAR ELAYNE (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:ELAYNE
Last Name:LICHKAY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:SKYLAR
Other - Middle Name:ELAYNE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3520 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1144
Mailing Address - Country:US
Mailing Address - Phone:678-978-6257
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-686-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270754363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care