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1013303650
KAYNESSA CELENA PROVIDENCE
MARIETTA, GA
NPI
1013303650
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: GA 86204)
Enumeration Date
2015-04-10
Last Update Date
2022-08-18
Business Address
Dr. KAYNESSA CELENA PROVIDENCE M.D.
54 TOWER RD NE
MARIETTA, GA 30060-6977
Phone number: 770-427-4682
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Mailing Address
Dr. KAYNESSA CELENA PROVIDENCE M.D.
54 TOWER RD NE
MARIETTA, GA 30060-6977
Phone number: 770-427-4682
Copy
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