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NPI Code Detail

MEDICARE: KATRINA ELIZABETH GRABLIN P.A-C

MEDICARE: KATRINA ELIZABETH GRABLIN P.A-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5837GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093938250
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA ELIZABETH GRABLIN P.A-C
Provider Business Mailing Address
First Line : 6665 WILL ALLEN RD
Second Line :
City : CUMMING
State : GA
Zip : 30040-6559
Country : US
Telephone Number : 229-603-1683
Fax Number :
Provider Business Practice Location Address
First Line : 13081 HIGHWAY 9 N
Second Line :
City : ALPHARETTA
State : GA
Zip : 30004-5150
Country : US
Telephone Number : 770-521-6690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 09/03/2024

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