Individual
MS. KACI ABSALOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5009 RIVERCHASE DR STE 500, PHENIX CITY, AL 36867-7490
(334) 448-9505
(334) 448-9575
Mailing address
5009 RIVERCHASE DR STE 500, PHENIX CITY, AL 36867-7490
(334) 448-9505
(334) 448-9575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-111962
AL
363LF0000X
Family Nurse Practitioner
RN177275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138582
—
GA
05
—
167806
—
AL
Enumeration date
12/10/2012
Last updated
02/14/2018
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