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General NPI Number Information
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NPI Number | 1710554464
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Entity Type | Organization
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Legal Business Name | MY HEALTH REASSURANCE P.C.
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 376 GLYNN ST N
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1191
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Country | US
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Telephone | 770-648-2148
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Fax | 676-788-2856
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Provider Business Mailing Address
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Address Line | P.O. BOX 142076
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City | FAYETTEVILLE
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State | GA
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Zip | 30214
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Country | UM
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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 | MRS. KAYONA J MORELAND
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Credential | FNP-C
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Telephone | 770-648-2148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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