MEDICARE: KALYNE MAYZIK NP-C

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
1	363LF0000X	Family Nurse Practitioner	RN237573	GA

General Provider Information

NPI Number	:	1518440346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALYNE MAYZIK NP-C

Provider Business Mailing Address
First Line	:	8022 ORCHARD HILL DR
Second Line	:
City	:	MIDLAND
State	:	GA
Zip	:	31820-4272
Country	:	US
Telephone Number	:	912-572-7318
Fax Number	:

Provider Business Practice Location Address
First Line	:	2827 WARM SPRINGS RD # 3B
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5246
Country	:	US
Telephone Number	:	706-324-4177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2018
Last Update Date	:	09/07/2018

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Directions to “ KALYNE MAYZIK NP-C” Practice Location

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