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MYKENNA NICHOLS DO
NPI 1346042330
Student in an Organized Health Care Education/Training Program in Marietta, GA

Active since March 27, 2025PECOS Enrolled
833 CAMPBELL HILL ST NW STE 250, MARIETTA, GA 30060(470) 956-2020(770) 999-2785 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mykenna Nichols Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYKENNA NICHOLS DO (NPI 1346042330) is an individual student in an organized health care education/training program in Marietta, Georgia and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346042330
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMYKENNA NICHOLSCredential: DO
Location Address833 CAMPBELL HILL ST NW STE 250Marietta, GA 30060-1162
Mailing Address677 Church St Ne Lowr LevelMarietta, GA 30060-1101
Phone(470) 956-2020
Fax(770) 999-2785
Sole ProprietorNo
Enumeration DateMarch 27, 2025
NPPES CertifiedMarch 27, 2025
✔ NPI 1346042330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
833 CAMPBELL HILL ST NW STE 250, Marietta, GA 30060
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mykenna Nichols Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAHMUT DEMIRTURK MD
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
DR. SARAH NICOLE NEAULT MD
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
JANE DAYOUNG NHO
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
AASHKA SHAH MD
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
MADISON ALEXANDRA MORGAN DO
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
AZIM FARISHTA
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
DR. AUSTIN T LIOU MD
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (470) 956-2020
STORMY M ORLIN MD
Student in an Organized Health Care Education/Training Program
833 CAMPBELL HILL ST NW STE 250
MARIETTA, GA 30060
Cobb County (770) 548-6766

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mykenna Nichols's NPI number?

The NPI number for Mykenna Nichols is 1346042330. It was assigned to this individual provider in the NPPES registry on March 27, 2025.

Where is Mykenna Nichols located?

Mykenna Nichols practices at 833 Campbell Hill St NW Ste 250, Marietta, GA 30060. The listed phone number is (470) 956-2020.

What is Mykenna Nichols's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mykenna Nichols enrolled in Medicare?

Yes. Mykenna Nichols is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mykenna Nichols was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.