Organization
ADVANCED PRACTICE TELEMEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E KITCHENS NP-C (BUSINESS OWNER)
(478) 443-0964
Entity
Organization
Contact information
Practice address
361 17TH ST NW UNIT 718, ATLANTA, GA 30363-1080
(478) 443-0964
Mailing address
361 17TH ST NW UNIT 718, ATLANTA, GA 30363-1080
(478) 443-0964
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/19/2021
Last updated
05/01/2025
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