Individual
JEEVANA KRISHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
765 LANIER 400 PKWY, CUMMING, GA 30040-2539
(770) 205-1294
(770) 205-1783
Mailing address
765 LANIER 400 PKWY, CUMMING, GA 30040-2539
(770) 205-1294
(770) 205-1783
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032759
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000579961C
—
GA
05
—
000579961G
—
GA
05
—
000579961H
—
GA
05
—
000579961I
—
GA
Enumeration date
04/05/2006
Last updated
02/26/2021
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