Healthcare Provider Details

I. General information

NPI: 1457292146
Provider Name (Legal Business Name): KRISTINA VENEZIA SALONE ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 HOWELL FERRY RD
DULUTH GA
30096-3178
US

IV. Provider business mailing address

3620 HOWELL FERRY RD
DULUTH GA
30096-3178
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-6800
  • Fax: 678-312-6982
Mailing address:
  • Phone: 678-312-6800
  • Fax: 678-312-6982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP280562
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: