Healthcare Provider Details

I. General information

NPI: 1588051882
Provider Name (Legal Business Name): KRISTI SONS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTI MCCRAY

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 04/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W LYON ST
TALLAPOOSA GA
30176-1288
US

IV. Provider business mailing address

119 AMBULANCE DR SUITE 202
CARROLLTON GA
30117-3857
US

V. Phone/Fax

Practice location:
  • Phone: 770-824-2800
  • Fax: 770-824-2810
Mailing address:
  • Phone: 770-838-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN198316
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: