Provider Demographics
NPI:1407562895
Name:POLLARD, KERICA HUTCHINSON
Entity Type:Individual
Prefix:
First Name:KERICA
Middle Name:HUTCHINSON
Last Name:POLLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 TEMPLETON LN
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-3622
Mailing Address - Country:US
Mailing Address - Phone:404-649-4294
Mailing Address - Fax:470-243-7328
Practice Address - Street 1:41 TEMPLETON LN
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-3622
Practice Address - Country:US
Practice Address - Phone:404-649-4294
Practice Address - Fax:470-243-7328
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN293414163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty