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General NPI Number Information
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NPI Number | 1982210860
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Entity Type | Individual
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Provider Name | KRISTI SUZANNE VINES WHNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 10692 MEDLOCK BRIDGE RD
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City | JOHNS CREEK
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State | GA
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Zip | 30097-1890
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Country | US
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Telephone | 404-446-2496
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 CAMERON DR
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City | GAINESVILLE
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State | GA
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Zip | 30506-8200
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Country | US
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Telephone | 770-298-3531
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN255722
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License Number State | GA
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