Healthcare Provider Details

I. General information

NPI: 1598676389
Provider Name (Legal Business Name): MICHAELA J MAHNKE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 N DRUID HILLS RD NE
ATLANTA GA
30329-3117
US

IV. Provider business mailing address

10 EXECUTIVE PARK WEST NE UNIT 160
ATLANTA GA
30329-2292
US

V. Phone/Fax

Practice location:
  • Phone: 916-943-5921
  • Fax:
Mailing address:
  • Phone: 916-943-5921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0200X
TaxonomyPediatric Pharmacist
License Number036398
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: