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Individual

CEYMONE PRIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
654 E 47TH ST, CHICAGO, IL 60653-4224
(773) 624-4800
Mailing address
220 BILL KENNEDY WAY SE, ATLANTA, GA 30316-7214
(678) 684-8049

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/27/2023
Last updated
02/06/2025
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