Healthcare Provider Details

I. General information

NPI: 1710812441
Provider Name (Legal Business Name): MILYNN LAWLESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 PEACHTREE RD NE
ATLANTA GA
30305-2414
US

IV. Provider business mailing address

129 RUE ROYAL
SLIDELL LA
70461-5220
US

V. Phone/Fax

Practice location:
  • Phone: 404-869-3308
  • Fax:
Mailing address:
  • Phone: 504-446-4983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036223
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: