MEDICARE: KIAUNA BENEFIELD

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	172A00000X	Driver

General Provider Information

NPI Number	:	1588364541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIAUNA BENEFIELD

Provider Business Mailing Address
First Line	:	1700 NORTHSIDE DR NW
Second Line	:	STE A7, PMB 2673
City	:	ATLANTA
State	:	GA
Zip	:	30318-2695
Country	:	US
Telephone Number	:	513-226-6857
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 NORTHSIDE DR NW
Second Line	:	STE A7, PMB 2673
City	:	ATLANTA
State	:	GA
Zip	:	30318-2695
Country	:	US
Telephone Number	:	513-226-6857
Fax Number	:

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

Provider Enumeration Date	:	03/08/2023
Last Update Date	:	03/08/2023

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Directions to “ KIAUNA BENEFIELD ” Practice Location

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