Basic Information
| Provider Information | |||||||||
| NPI: | 1679015390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARR | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | PEREZ | ||||||||
| NamePrefix: | |||||||||
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| Credential: | NP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | PEREZ | ||||||||
| OtherFirstName: | KATHRYN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1800 HOWELL MILL RD NW | ||||||||
| Address2: | SUITE 800 AND 775 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303182538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043509853 | ||||||||
| FaxNumber: | 4044771162 | ||||||||
| Practice Location | |||||||||
| Address1: | 1267 HIGHWAY 54 W STE 4200 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302142112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788291060 | ||||||||
| FaxNumber: | 4044771162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2016 | ||||||||
| LastUpdateDate: | 11/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN216688 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.