Provider Demographics
NPI:1063062743
Name:HARPE, KANECIA MONAY
Entity type:Individual
Prefix:
First Name:KANECIA
Middle Name:MONAY
Last Name:HARPE
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 1:1015 CAMILLA ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314-3132
Mailing Address - Country:US
Mailing Address - Phone:404-641-4742
Mailing Address - Fax:
Practice Address - Street 1:1015 CAMILLA ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-3132
Practice Address - Country:US
Practice Address - Phone:404-641-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor