Naneka S Kennon Pam, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN275536 Issued in GA

Practice address

3469 Henley St
Rex, GA 30273-1758

Phone

(404) 552-1125

NPI assigned

Jan 17, 2020

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clara'S Home Healthcare Institute

  • Nursing Care Agency
  • Rex, GA
  • NPI 1104431758
  NPD

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 17, 2020.

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1265062335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 HENLEY ST",
            "city": "REX",
            "state": "GA",
            "postal_code": "302731758",
            "telephone_number": "404-552-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 HENLEY ST",
            "city": "REX",
            "state": "GA",
            "postal_code": "302731758",
            "telephone_number": "404-552-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON PAM",
        "first_name": "NANEKA",
        "middle_name": "S",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN275536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sallie Johnson, RN
• Trenese Marie Johnson, LCSW
• Jovans Pharmacy Corp
• Joseph Jupiter
• Keep Inspiring Dreams Inc
• KLB Transportation Services LLC
• KMR LLC
• Michele' Lambert-Watkins, PH.D
• Clarissa Lewis, LPC, CPCS
• LJB Non Medical Transportation

• All providers in Rex, GA
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.