MEDICARE: MARISSA B HIGHNOTE PA-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	363AS0400X	Surgical Physician Assistant	006838	GA

General Provider Information

NPI Number	:	1336587401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA B HIGHNOTE PA-C

Provider Business Mailing Address
First Line	:	6045 BARFIELD RD STE 100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4402
Country	:	US
Telephone Number	:	404-250-3333
Fax Number	:	404-250-0175

Provider Business Practice Location Address
First Line	:	6045 BARFIELD RD STE 100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-4402
Country	:	US
Telephone Number	:	404-250-3333
Fax Number	:	404-250-0175

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

Provider Enumeration Date	:	06/11/2013
Last Update Date	:	03/17/2018

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Directions to “ MARISSA B HIGHNOTE PA-C” Practice Location

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