Individual
YASHATE KINKIA PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2159 GROVE LANDING WAY, GROVETOWN, GA 30813-7017
(843) 356-3374
Mailing address
2159 GROVE LANDING WAY, GROVETOWN, GA 30813-7017
(843) 356-3374
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
107470
SC
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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