Individual
KEYANNA ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
(770) 921-3565
Mailing address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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