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General NPI Number Information
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NPI Number | 1376455451
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Entity Type | Organization
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Legal Business Name | KIDNEY CARE CLINIC LLC
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 1505 NORTHSIDE BLVD STE 3400
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City | CUMMING
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State | GA
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Zip | 30041-8223
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Country | US
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Telephone | 205-552-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 15555 NE 68TH CT
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City | REDMOND
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State | WA
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Zip | 98052-4829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHUSHLEEN JAGGI
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Credential |
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Telephone | 205-552-9221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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