Individual
KEISHA RASHAUNE IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6690 ROSWELL RD STE 404, SANDY SPRINGS, GA 30328-3161
(470) 888-8377
Mailing address
PO BOX 672151, MARIETTA, GA 30006-0036
(770) 940-0388
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
103058
HI
163W00000X
Registered Nurse
833865
NY
163W00000X
Registered Nurse
Primary
RN250828
GA
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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