Individual
KISA MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MHS
Contact information
Practice address
960 JOHNSON FY RD NE STE 335, ATLANTA, GA 30342-1625
(404) 497-8700
Mailing address
960 JOHNSON FY RD NE STE 335, ATLANTA, GA 30342-1625
(404) 497-8700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11890
GA
363AS0400X
Surgical Physician Assistant
11890
GA
Other
Enumeration date
08/21/2023
Last updated
07/22/2024
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