Individual
KADASHA FAIRCLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1340 ALEXANDER XING, LOGANVILLE, GA 30052-3985
(404) 916-9226
Mailing address
1340 ALEXANDER XING, LOGANVILLE, GA 30052-3985
(404) 916-9226
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN286337
GA
367500000X
Certified Registered Nurse Anesthetist
0024190568
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN286337
GA
Other
Enumeration date
11/23/2019
Last updated
07/23/2026
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