Healthcare Provider Details

I. General information

NPI: 1568379840
Provider Name (Legal Business Name): NANNONO MARIA KAYONDO FNP -C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 DAWSON COMMONS CIR
DAWSONVILLE GA
30534-6268
US

IV. Provider business mailing address

220 HOGAN RD
CLEVELAND GA
30528-5424
US

V. Phone/Fax

Practice location:
  • Phone: 706-216-2771
  • Fax:
Mailing address:
  • Phone: 706-973-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP289829
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: