Basic Information
Provider Information
NPI: 1922471630
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HO
FirstName: KAI-TIEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AGACNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 550 PEACHTREE STREET - DAVIS FISCHER BUILD
Address2: 3245A EMORY CENTER FOR CRITICAL CARE
City: ATLANTA
State: GA
PostalCode: 30308
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 550 PEACHTREE STREET
Address2: 3245A EMORY CENTER FOR CRITICAL CARE
City: ATLANTA
State: GA
PostalCode: 30308
CountryCode: US
TelephoneNumber: 4047122000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/03/2015
LastUpdateDate: 11/03/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100XRN204708GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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