Individual
ITI KANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
138 W GIBSON ST, HARTWELL, GA 30643-1847
(706) 376-6200
Mailing address
1061 DOWDY RD STE 100, ATHENS, GA 30606-5700
(706) 621-7575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN223738
GA
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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