Individual
SELENA KEENAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-8570
(404) 778-8562
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 580-8570
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN094338
GA
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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