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NPI Code Detail

MEDICARE: KENYETTA MASHANNA CHRISTMAS APRN-BC

MEDICARE: KENYETTA MASHANNA CHRISTMAS APRN-BC
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
1363LA2100XAcute Care Nurse PractitionerRN165675GA

General Provider Information

NPI Number : 1467625038
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENYETTA MASHANNA CHRISTMAS APRN-BC
Provider Business Mailing Address
First Line : 55 WHITCHER ST NE STE 130
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1156
Country : US
Telephone Number : 770-428-0462
Fax Number : 770-427-8001
Provider Business Practice Location Address
First Line : 55 WHITCHER ST NE STE 130
Second Line :
City : MARIETTA
State : GA
Zip : 30060-1156
Country : US
Telephone Number : 770-428-0462
Fax Number : 770-427-8001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2008
Last Update Date : 04/14/2024

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Directions to “ KENYETTA MASHANNA CHRISTMAS APRN-BC” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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