Healthcare Provider Details

I. General information

NPI: 1215769674
Provider Name (Legal Business Name): MILAIKA MICOLE PICKARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MACON RD STE 109B
COLUMBUS GA
31906-1717
US

IV. Provider business mailing address

1525 BURRUS DR
COLUMBUS GA
31904-3219
US

V. Phone/Fax

Practice location:
  • Phone: 706-225-8773
  • Fax:
Mailing address:
  • Phone: 762-822-9535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP271239
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN271239
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: