Provider Demographics
NPI:1851988703
Name:BRUNSON ALLMOND, KEYNOCHA (MHA, CMA, CPTI)
Entity Type:Individual
Prefix:
First Name:KEYNOCHA
Middle Name:
Last Name:BRUNSON ALLMOND
Suffix:
Gender:F
Credentials:MHA, CMA, CPTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 DULUTH HIGHWAY 120 STE 206
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3345
Mailing Address - Country:US
Mailing Address - Phone:844-542-9720
Mailing Address - Fax:
Practice Address - Street 1:3327 DULUTH HIGHWAY 120 STE 206
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3345
Practice Address - Country:US
Practice Address - Phone:844-542-9720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-27
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374U00000XNursing Service Related ProvidersHome Health Aide
No174H00000XOther Service ProvidersHealth Educator