Provider Demographics
NPI:1447011697
Name:MAGERL, KADIAN K
Entity type:Individual
Prefix:
First Name:KADIAN
Middle Name:K
Last Name:MAGERL
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 1:6021 SIMONE ST
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-0049
Mailing Address - Country:US
Mailing Address - Phone:678-820-1172
Mailing Address - Fax:
Practice Address - Street 1:6021 SIMONE ST
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-0049
Practice Address - Country:US
Practice Address - Phone:678-820-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN315764163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse