Provider Demographics
NPI:1689428419
Name:MYKHAYLOVA, ARGENTINA VIKTOROVNA (FNP)
Entity type:Individual
Prefix:
First Name:ARGENTINA
Middle Name:VIKTOROVNA
Last Name:MYKHAYLOVA
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-4842
Mailing Address - Country:US
Mailing Address - Phone:678-237-7077
Mailing Address - Fax:
Practice Address - Street 1:3240 S COBB DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4194
Practice Address - Country:US
Practice Address - Phone:770-433-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN251882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily