Individual
KISHAUNA REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 NORTHEAST EXPY NE, BROOKHAVEN, GA 30329-2401
(678) 577-2085
Mailing address
554 ASHTON MANOR DR, LOGANVILLE, GA 30052-5389
(678) 577-2085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN292897
GA
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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