Individual
KYLE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1975 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4794
(770) 632-3730
(770) 632-3731
Mailing address
171 OLD ROSSER RD, STONE MOUNTAIN, GA 30087-2509
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN153892
GA
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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