Individual
KETSIA DAJUSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 AMHERST DR, WINDER, GA 30680-7463
(470) 900-4368
Mailing address
1496 CASTLEBERRY DR, BUFORD, GA 30518-5069
(678) 200-7938
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13957
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2024
Last updated
05/26/2026
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