Individual
KENNETH D PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-1900
Mailing address
615 CLIFTON RD NE, ATLANTA, GA 30307-1709
(404) 378-7457
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN136610
GA
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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