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Mrs. Kimberly Lacynthia Logan, APRN
Family Nurse Practitioner in Chatsworth, Georgia
NPI 1417147463

Kimberly Lacynthia Logan is a Family Nurse Practitioner based in Chatsworth, GA and is specialized in Family. Kimberly Lacynthia Logan practices in Chatsworth, GA and has the professional credentials of APRN. The NPI Number for Kimberly Lacynthia Logan is 1417147463 and holds a License No. 9166317 (Georgia).

The current practice location address for Kimberly Lacynthia Logan is 1440 Jackson Lake Rd, Chatsworth, GA and can be reached out via phone at 904-377-3301.

Location: 1440 Jackson Lake Rd, Chatsworth, GA, 30705-4109
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417147463
Provider Name
Kimberly Lacynthia Logan
Credential
APRN
Provider Entity Type
Individual
Gender
Female
Address
1440 Jackson Lake Rd, Chatsworth, GA, 30705-4109
Phone Number
904-377-3301
Fax Number
Provider Enumeration Date
07/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001458200 05 FL
institution
Provider Business Practice Location Address Details
Address
1440 Jackson Lake Rd
City
Chatsworth
State
Georgia
Zip
30705-4109
Phone Number
904-377-3301
Fax Number
person
Provider Business Mailing Address Details
Address
1440 Jackson Lake Rd
City
Chatsworth
State
Georgia
Zip
30705-4109
Phone Number
904-377-3301
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
9166317 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
9166317 (Florida)
Definition
Definition to come...
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