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Individual

KYLIE HUMPHRIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-S

Contact information

Practice address
124 BRIARVISTA WAY NE, ATLANTA, GA 30329-3614
(954) 415-7722
Mailing address
124 BRIARVISTA WAY NE, ATLANTA, GA 30329-3614
(954) 415-7722

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
10/24/2022
Last updated
10/24/2022
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