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NPI Code Detail

MEDICARE: KALNETTIE DESHOND CAYMAN MSN, APRN, FNP-BC

MEDICARE: KALNETTIE DESHOND CAYMAN MSN, APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner10632WI
2363LF0000XFamily Nurse PractitionerRN245062GA

General Provider Information

NPI Number : 1144862806
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALNETTIE DESHOND CAYMAN MSN, APRN, FNP-BC
Provider Business Mailing Address
First Line : 101 LEXINGTON CIR
Second Line :
City : PEACHTREE CITY
State : GA
Zip : 30269-6845
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 LEXINGTON CIR
Second Line :
City : PEACHTREE CITY
State : GA
Zip : 30269-6845
Country : US
Telephone Number : 770-486-1639
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2019
Last Update Date : 01/29/2024

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