KISHA ADDERLEY (NPI# 1174921175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174921175 |
| Entity Type | Individual |
| Full Name | KISHA ADDERLEY |
| Credential | FNP |
| Practice Address |
1775 Parker Rd Se Ste C-240 Conyers GA 30094-6654 |
| Mailing Address |
Po Box 116202 Atlanta GA 30368-6202 |
| Practice Telephone | 6786096282 |
| Practice Fax Number | 6786096283 |
| Mailing Telephone | 6786096282 |
| Mailing Fax Number | 6786096283 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN185219 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1775 PARKER RD SE STE C-240 |
| City | CONYERS |
| State | GA |
| Zip Code | 30094-6654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235221946 | Stephanie E Wilson | Pediatrics | 1775 Parker Rd Se, B210, Conyers, GA 30094-6654 | 2006-09-29 |
| 1699395301 | Reflections Therapeutic Services, LLC | Counselor | 1775 Parker Rd Se, Conyers, GA 30094-6654 | 2020-04-22 |
| 1922667039 | Jeneifer Threadcraft | Psychologist | 1775 Parker Rd Se, Conyers, GA 30094-6654 | 2019-06-12 |
| 1902332562 | Latisha Woods | Counselor | 1775 Parker Rd Se, Bldg C, Suite 210, Conyers, GA 30094-6654 | 2017-05-02 |
| 1821489485 | Elizabeth Ann Mcelmurry | Physician Assistant | 1775 Parker Rd Se, Conyers, GA 30094-6654 | 2015-02-17 |
| 1437472511 | Rockdale Physician Practices LLC | Family Medicine | 1775 Parker Rd Se, Suite C240, Conyers, GA 30094-6654 | 2010-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082283 | Helen King-cox | Nurse Practitioner | 1650 Honey Creek Cmns Se, Conyers, GA 30013-5831 | 2020-10-26 |
| 1982202644 | Kathy Delaine Reid | Nurse Practitioner | 2324 Wilson Rd Nw, Conyers, GA 30012-2720 | 2020-10-15 |
| 1720606437 | Natalie Shelton | Nurse Practitioner | 1950 Lancaster Dr Se, Conyers, GA 30013-6442 | 2020-07-09 |
| 1013561323 | Assumpta Ogbedeagu | Nurse Practitioner | 2920 Highway 138 Ne, Conyers, GA 30013-1110 | 2019-07-25 |
| 1528611522 | Danyelle M Smith | Nurse Practitioner | 1755 Parker Rd Se Ste A120, Conyers, GA 30094-6665 | 2019-07-18 |
| 1013475110 | Cecelin E Fields | Nurse Practitioner | 1706 Woodstone Cv Se, Conyers, GA 30013-6303 | 2019-03-07 |
| 1851858914 | Moun E. Thomas | Nurse Practitioner | 2405 Hyde Park Ct, Conyers, GA 30013-7434 | 2019-02-25 |
| 1972075919 | Candice Mooyin | Nurse Practitioner | 1506 Klondike Rd Sw Ste 250, Conyers, GA 30094-5173 | 2018-12-31 |
| 1801362140 | Linda M Leiser | Nurse Practitioner | 1066 Plantation Blvd Se, Conyers, GA 30094-4120 | 2018-10-14 |
| 1356822126 | Glory Dioh-esona | Nurse Practitioner | 2340 Deeside Se, Conyers, GA 30013-6470 | 2018-08-28 |
| Find all providers in CONYERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.