MEDICARE: KAITLIN MARIE WEISSHAPPEL

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	207SG0201X	Clinical Genetics (M.D.) Physician	80499	MN
2	207SG0207X	Medical Biochemical Genetics	80499	MN

General Provider Information

NPI Number	:	1720615834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN MARIE WEISSHAPPEL

Provider Business Mailing Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-778-1440
Fax Number	:	404-778-1401

Provider Business Practice Location Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-778-1440
Fax Number	:

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

Provider Enumeration Date	:	03/26/2020
Last Update Date	:	12/31/2025

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