Mitchell, Kenennesha Latasha

Mitchell, Kenennesha Latasha is an individual health care provider with primary practice located at 2467 Golden Camp Rd , Augusta GA 30906-5515. She recently has only one registered license in Emergency Medical Service Providers / Emergency Medical Technician, Intermediate, which is considered as her primary health care specialty. Mitchell, Kenennesha Latasha can be contacted via phone (706) 790-4440.

Contact Information

Primary practice address
2467 Golden Camp Rd Augusta GA 30906-5515
Phone: (706) 790-4440
Fax: (706) 790-4393
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Emergency Medical Service Providers / Emergency Medical Technician, Intermediate 146M00000X 29545 Georgia

Profile Details

NPI number 1861746745
LBN Legal business name Mitchell, Kenennesha Latasha
Credentials EMT-I
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2012
Last updated Oct 31st, 2012 - about 13 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 1861746745 NPPES
Georgia Other 29545 EMT-I

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