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

Individual provider Prosthetist · NPI 1912545393

Kanishia Gordon, HAIRREPLSPECIALIST is a Prosthetist in Atlanta, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2019
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Practice location Address checks out

519 Memorial Dr SE Ste 209
Atlanta, GA 30312-2286
Phone: (404) 836-3845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetist (primary) Taxonomy 224P00000X (GA)

Record details

NPI number1912545393
Entity typeIndividual (Type 1)
GenderFemale
Credentials HAIRREPLSPECIALIST
Sole proprietorYes
NPI enumeratedDecember 16, 2019
Last updated in NPPESDecember 16, 2019
Certification dateDecember 16, 2019

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