Individual
KISA HUENINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1790 MULKEY RD STE 8A, AUSTELL, GA 30106-1122
(770) 944-1830
(770) 739-0260
Mailing address
1790 MULKEY RD STE 8A, AUSTELL, GA 30106-1122
(770) 944-1830
(770) 739-0260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
211443
GA
Other
Enumeration date
05/13/2019
Last updated
12/20/2019
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