MEDICARE: CARLA KINSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1003685678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA KINSEY

Provider Business Mailing Address
First Line	:	4519 WOODRUFF RD, STE 4
Second Line	:	BOX 1015
City	:	COLUMBUS
State	:	GA
Zip	:	31904
Country	:	US
Telephone Number	:	770-728-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 MILGEN RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5889
Country	:	US
Telephone Number	:	770-728-5446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/25/2023
Last Update Date	:	12/25/2023

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Directions to “ CARLA KINSEY ” Practice Location

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