Individual
KENYA MARIAN GASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
417 LEWISTON RD, GROVETOWN, GA 30813-4287
(404) 477-7376
Mailing address
4007 CORNERS WAY, GROVETOWN, GA 30813-1247
(404) 477-7376
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN270103
GA
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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