Individual
KEISHA ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1311 MILSTEAD AVE NE STE 321, CONYERS, GA 30012-3829
(678) 599-9800
Mailing address
1311 MILSTEAD AVE NE STE 321, CONYERS, GA 30012-3829
(678) 599-9800
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
C9P8A7M3
GA
Other
Enumeration date
08/02/2024
Last updated
08/14/2024
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