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General NPI Number Information
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NPI Number | 1194550129
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Entity Type | Individual
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Provider Name | KALEIGH HERRON NP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 187 CHASTAIN RD NW STE 250
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City | KENNESAW
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State | GA
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Zip | 30144-3010
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Country | US
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Telephone | 770-218-6450
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Fax |
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Provider Business Mailing Address
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Address Line | 732 FRASIER CIR SE
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City | MARIETTA
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State | GA
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Zip | 30060-2316
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Country | US
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Telephone | 239-634-7026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | RN333777
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN333777
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License Number State | GA
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