Basic Information
Provider Information
NPI: 1831632504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GARFINKEL
FirstName: KIERNAN
MiddleName: CALEF
NamePrefix: MRS.
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CALEF
OtherFirstName: KIERNAN
OtherMiddleName: KAYNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1968 PEACHTREE RD NW
Address2:  
City: ATLANTA
State: GA
PostalCode: 303091281
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber:  
Practice Location
Address1: 1968 PEACHTREE RD NW
Address2:  
City: ATLANTA
State: GA
PostalCode: 303091281
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/29/2016
LastUpdateDate: 02/15/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN220589GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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