Individual
KENISHA TEREE FUNCHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 FIVE IRON CT NW, KENNESAW, GA 30144-5065
(405) 436-5436
Mailing address
200 FIVE IRON CT NW, KENNESAW, GA 30144-5065
(405) 436-5436
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN093821
GA
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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