Individual
KALIANNA MARIE PIVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1400 RIVER PL, BRASELTON, GA 30517-5600
(770) 848-8000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12454
GA
Other
Enumeration date
05/09/2024
Last updated
07/18/2024
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