Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nurse Practioner

Organization Community Health Clinic/Center · NPI 1629519202

Nurse Practioner is a Community Health Clinic/Center in Kennesaw, Georgia. Licensed in Georgia. Registered with an NPI since 2017.

Licensed in
GA
In the registry since
2017
Specialties on file
2

Practice location Address checks out

4044 George Busbee Pkwy NW Apt 4207
Kennesaw, GA 30144-6890
Phone: (404) 579-1658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Clinic/Center (primary) Taxonomy 261QC1500X · Licence 193760 (GA)
Point of Service Taxonomy 305S00000X · Licence 193760 (GA)

Record details

NPI number1629519202
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationIndependent Contractor
Authorized official Rose Kombe — Fnp · (404) 579-1658
NPI enumeratedMarch 15, 2017
Last updated in NPPESMarch 15, 2017
Mailing addressPo Box 1234, Powder Springs, GA 30127-7234

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