Mccollum, Kennon Howard

Mccollum, Kennon Howard is an individual health care provider with primary practice located at 1045 Southcrest Dr Suite 200, Stockbridge GA 30281-6113. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Mccollum, Kennon Howard can be contacted via phone (678) 289-0549.

Contact Information

Primary practice address
1045 Southcrest Dr Suite 200 Stockbridge GA 30281-6113
Phone: (678) 289-0549
Fax: (678) 289-8756
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN102128 Georgia

Profile Details

NPI number 1427036409
LBN Legal business name Mccollum, Kennon Howard
Credentials Master of Science in Nursing (MSN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Aug 19th, 2020 - about 4 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 1427036409 NPPES
Georgia MEDICAID 000968745J
Georgia MEDICAID 000968745K
Georgia MEDICAID 000968745H

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