Individual
MRS. KIA HEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 BOMBAY LANE, ROSWELL, GA 30076
(770) 754-4674
Mailing address
601 BOMBAY LANE, ROSWELL, GA 30076
(770) 754-4674
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN072189
GA
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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