Individual
KAYLISA JANE PEGUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(770) 334-1714
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN-NP323827
GA
363LF0000X
Family Nurse Practitioner
Primary
RN323827
GA
Other
Enumeration date
02/03/2025
Last updated
10/24/2025
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