1346588209 NPI number — MS. KAYON ELAINE SINCLAIR DNP,FNP/BC

Table of content: MS. KAYON ELAINE SINCLAIR DNP,FNP/BC (NPI 1346588209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346588209 NPI number — MS. KAYON ELAINE SINCLAIR DNP,FNP/BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINCLAIR
Provider First Name:
KAYON
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DNP,FNP/BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SINCLAIR
Provider Other First Name:
KAYON
Provider Other Middle Name:
AYTON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346588209
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3721 NEW MACLAND RD STE 205-265
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWDER SPRINGS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30127-2000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-727-5108
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3226 OAK ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30106-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-727-5108
Provider Business Practice Location Address Fax Number:
877-817-2850
Provider Enumeration Date:
01/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  179410 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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