Individual
KEN LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
1404 RIVER PL STE 501, BRASELTON, GA 30517-5600
(770) 534-2020
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN299278
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN299278
GA
Other
Enumeration date
12/18/2024
Last updated
02/19/2025
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