Individual
KRISTINE AIBANGBEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 LAKE PARK DR SE APT J, SMYRNA, GA 30080-7670
(615) 836-8085
Mailing address
2135 LAKE PARK DR SE APT J, SMYRNA, GA 30080-7670
(615) 836-8085
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHCP01529
—
GA
Enumeration date
10/24/2019
Last updated
10/24/2019
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