MEDICARE: KATHERINE NICOLE CHRISMER FNP-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
1	363LP2300X	Primary Care Nurse Practitioner	216231	GA

General Provider Information

NPI Number	:	1144563834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE NICOLE CHRISMER FNP-C

Provider Business Mailing Address
First Line	:	3161 HOWELL MILL RD NW
Second Line	:	SUITE 400
City	:	ATLANTA
State	:	GA
Zip	:	30327-2135
Country	:	US
Telephone Number	:	404-351-5812
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 HOWELL MILL RD NW
Second Line	:	SUITE 400
City	:	ATLANTA
State	:	GA
Zip	:	30327-2135
Country	:	US
Telephone Number	:	404-351-5812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	04/01/2013

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