MEDICARE: KIM MESSINA

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	163W00000X	Registered Nurse	RN076356	GA

General Provider Information

NPI Number	:	1861980120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM MESSINA

Provider Business Mailing Address
First Line	:	55 BEATTIE PL STE 810
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2191
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 CARPENTER DR STE 101
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4909
Country	:	US
Telephone Number	:	470-312-2933
Fax Number	:

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

Provider Enumeration Date	:	04/23/2018
Last Update Date	:	04/23/2018

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Directions to “ KIM MESSINA ” Practice Location

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