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Contact Information

RAYLLENSONS ITACY, PA
2020 CUMMING HIGHWAY
SUITE 102
CANTON, GA30115
 Phone: 678-593-1295
 Fax: 678-593-1294
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for RAYLLENSONS ITACY · (Female)

NPI # 1174804702
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/09/2011
Last updated 04/05/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 006147
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL CHEROKEE - (Acute Care)
    201 HOSPITAL ROAD
    CANTON, GA 30114
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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