Individual
MISS KAYLA JUSTINE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3422 SIXES RD STE 102, CANTON, GA 30114-9120
(943) 202-7670
Mailing address
388 4TH ST NE, ATLANTA, GA 30308-2005
(317) 600-8717
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN267058
GA
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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