Provider Demographics
NPI:1295613180
Name:MCEACHERN, KRISHNA (CCP, LP)
Entity type:Individual
Prefix:
First Name:KRISHNA
Middle Name:
Last Name:MCEACHERN
Suffix:
Gender:F
Credentials:CCP, LP
Other - Prefix:
Other - First Name:KRISHNA
Other - Middle Name:
Other - Last Name:PHIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCP, LP
Mailing Address - Street 1:3890 FLOYD RD APT 12102
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1785
Mailing Address - Country:US
Mailing Address - Phone:703-655-6458
Mailing Address - Fax:
Practice Address - Street 1:677 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1101
Practice Address - Country:US
Practice Address - Phone:770-793-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA453242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist