Provider Demographics
NPI:1841839792
Name:DIGGS, KJUANA (HAIR LOSS PRACTITION)
Entity type:Individual
Prefix:
First Name:KJUANA
Middle Name:
Last Name:DIGGS
Suffix:
Gender:F
Credentials:HAIR LOSS PRACTITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12830 ENGLISH WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-5027
Mailing Address - Country:US
Mailing Address - Phone:704-961-8218
Mailing Address - Fax:
Practice Address - Street 1:8510 MCALPINE PARK DR STE 209
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-6250
Practice Address - Country:US
Practice Address - Phone:980-494-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-24
Last Update Date:2022-02-11
Deactivation Date:2019-12-24
Deactivation Code:
Reactivation Date:2022-02-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty