Individual
KANEISIA SANSONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2411
Mailing address
565 GEORGIA CIR, LOGANVILLE, GA 30052-6938
(334) 379-1891
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
288921
NC
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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