Kendrick, Stacy H.

Kendrick, Stacy H. is an individual health care provider with primary practice located at 2041 Mesa Valley Way Suite 100, Austell GA 30106-8157. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kendrick, Stacy H. can be contacted via phone (770) 944-1100.

Contact Information

Primary practice address
2041 Mesa Valley Way Suite 100 Austell GA 30106-8157
Phone: (770) 944-1100
Fax: (770) 944-6469
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004549 Georgia

Profile Details

NPI number 1821064395
LBN Legal business name Kendrick, Stacy H.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Feb 5th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821064395 NPPES
Georgia MEDICAID 407818938A
Georgia MEDICAID 407818938C
Georgia MEDICAID 407818938D

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