KANISHIA GORDON (HAIR REPL SPECIALIST) – Prosthetist, NPI 1912545393

KANISHIA GORDON (HAIR REPL SPECIALIST) is a healthcare provider. based in Stone mountain, Georgia. specializing in Prosthetist. They hold the professional credentials HAIR REPL SPECIALIST. The NPI Number for KANISHIA GORDON (HAIR REPL SPECIALIST) is 1912545393

Main info

Female
Sole Proprietor
Name
KANISHIA GORDON (HAIR REPL SPECIALIST)
NPI
1912545393
Phone
(203) 565-5872
Address
2025 CLEARSTREAM OVERLOOK
Enumeration Date
16 December 2019
Last Update Date
16 December 2019
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:6State licenses:0Digital endpointsOther names

Provider Addresses for KANISHIA GORDON (HAIR REPL SPECIALIST)

  • 2025 CLEARSTREAM OVERLOOK

    STONE MOUNTAIN, GA 300884438

    Phone: (203) 565-5872

    Type: Mailing

  • 519 MEMORIAL DR SE STE 209

    ATLANTA, GA 303122286

    Phone: (404) 836-3845

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30088)

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Reviews

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Frequently asked questions

Is KANISHIA GORDON (HAIR REPL SPECIALIST) listed with a National Provider Identifier?
Yes — KANISHIA GORDON (HAIR REPL SPECIALIST) has NPI 1912545393 on file in the registry.
Active or inactive — what applies to KANISHIA GORDON (HAIR REPL SPECIALIST)?
You should see KANISHIA GORDON (HAIR REPL SPECIALIST) as active in CMS-hosted NPPES data.
What area of care is associated with KANISHIA GORDON (HAIR REPL SPECIALIST)?
KANISHIA GORDON (HAIR REPL SPECIALIST)'s record emphasizes Prosthetist. Clinical services aligned with this taxonomy classification.
Is KANISHIA GORDON (HAIR REPL SPECIALIST) located near Stone Mountain?
KANISHIA GORDON (HAIR REPL SPECIALIST) currently maps to Stone Mountain, Georgia in this extract.
When was this NPI issued?
Enumeration for KANISHIA GORDON (HAIR REPL SPECIALIST) is noted as December 16, 2019 where the registry provides it.

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