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General NPI Number Information
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NPI Number | 1295112662
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Entity Type | Individual
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Provider Name | ASHLEY KISH AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 2727 PACES FERRY RD SE SUITE 1-1100
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City | ATLANTA
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State | GA
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Zip | 30339-4053
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Country | US
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Telephone | 404-605-4602
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 RIDENOUR PKWY NW APT 2306
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City | KENNESAW
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State | GA
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Zip | 30152-4714
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Country | US
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Telephone | 678-358-3347
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN209909
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License Number State | GA
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