Individual provider · Type 1 NPI
Yashate Kinkia Pendergrass, RN
Community Health Registered Nurse · Grovetown, GA
NPI number
1508325242
Active
Practice location
2159 Grove Landing Way
Grovetown, GA 30813-7017
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Registered Nurse Primary | 163WC1500X | 107470 (SC) |
Community Health Registered Nurse: Definition to come...
About NPI 1508325242
Yashate Kinkia Pendergrass, RN's National Provider Identifier is 1508325242, issued on Mar 12, 2019. The primary taxonomy on file is Community Health Registered Nurse (163WC1500X), and the practice location is in Grovetown, GA. The record was last updated on Mar 12, 2019.