Healthcare Provider Details

I. General information

NPI: 1154331668
Provider Name (Legal Business Name): JENNIFER E KOLENDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

3779 CLIFF CREST DR SE
SMYRNA GA
30080-5880
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-1855
  • Fax:
Mailing address:
  • Phone: 404-423-3511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN157259
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: