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Individual

KAILYN SLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5185 OLD NATIONAL HWY, ATLANTA, GA 30349-3244
(404) 763-9300
Mailing address
1205 METROPOLITAN AVE SE APT 333, ATLANTA, GA 30316-1987
(478) 396-1147

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN227754
GA
363LC0200X
Critical Care Medicine Nurse Practitioner
RN22754
GA
363LF0000X
Family Nurse Practitioner
Primary
RN227754
GA

Other

Enumeration date
08/08/2018
Last updated
10/03/2019
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