Healthcare Provider Details

I. General information

NPI: 1437063633
Provider Name (Legal Business Name): MYKA TOIANN LEMON BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 BURNT HICKORY RD
POWDER SPRINGS GA
30127-3057
US

IV. Provider business mailing address

5715 BURNT HICKORY RD
POWDER SPRINGS GA
30127-3057
US

V. Phone/Fax

Practice location:
  • Phone: 678-576-0378
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN335083
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: