Kizzie Idella Enoch

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN078944 Issued in GA

Practice address

130 Birch St
Hiram, GA 30141-4171

Phone

(770) 367-5357

NPI assigned

May 2, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Divinequest Corporation

  • Case Management Registered Nurse
  • Hiram, GA
  • NPI 1598612764
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773532800000",
    "number": "1992763890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BIRCH ST",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301414171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BIRCH ST",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301414171",
            "telephone_number": "770-367-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENOCH",
        "first_name": "KIZZIE",
        "middle_name": "IDELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-03-15",
        "certification_date": "2026-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "LA",
            "license": "910718",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN078944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid A Ellison, M.D.
• Benjamin Emareyo
• Embrace Counseling and Consulting, LLC
• Kathleen Elizabeth Empen, M.D.
• Empowered2Change LLC
• Matthew Lee Estes, NP-C
• Kelley Lyn Etheridge, ATC
• Denise Rae Etter, PT
• Evergreen Counseling, LLC
• Gabriel Everson, FNP-C

• Licensed Practical Nurse in Hiram, GA
• Providers in Hiram, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2026; 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.