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General NPI Number Information
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NPI Number | 1154053510
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Entity Type | Organization
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Legal Business Name | KAYS URGENT CARE CLINIC LLC
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Dates
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Enumeration Date | 06/25/2022
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 4171 MARIETTA ST
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-2696
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Country | US
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Telephone | 678-549-2323
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Fax | 404-609-1268
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Provider Business Mailing Address
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Address Line | 4171 MARIETTA ST
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-2696
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Country | US
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Telephone | 678-549-2323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAY YETUNDE JOHNSON
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Credential | NP
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Telephone | 678-549-2323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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