# KEMBERLY AMANDA STONE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639208333
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 05480 | GA | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 03/02/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05480 | GEORGIA MEDICAL LICENSE NUMBER: 05480 EXPIRATION 01/31/2016 | GA |