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1124645395
KISHA SMALLEY
MCDONOUGH, GA
NPI
1124645395
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: GA F07200350)
Enumeration Date
2020-07-02
Last Update Date
2020-07-02
Business Address
KISHA SMALLEY FNP
117 GAMBIER CV
MCDONOUGH, GA 30252-6273
Phone number: 904-536-3032
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Mailing Address
KISHA SMALLEY FNP
117 GAMBIER CV
MCDONOUGH, GA 30252-6273
Phone number: 904-536-3032
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