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NPI Code Detail

MEDICARE: KASANDRA S JEAN-LOUIS PMHNP

MEDICARE: KASANDRA S JEAN-LOUIS PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerNP254144GA

General Provider Information

NPI Number : 1902745169
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASANDRA S JEAN-LOUIS PMHNP
Provider Business Mailing Address
First Line : 1860 SANDY PLAINS RD SUITE 204
Second Line : #2113
City : MARIETTA
State : GA
Zip : 30066-7864
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1121 JOHNSON FERRY RD STE 450
Second Line :
City : MARIETTA
State : GA
Zip : 30068-5433
Country : US
Telephone Number : 706-740-7654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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