Healthcare Provider Details

I. General information

NPI: 1043034762
Provider Name (Legal Business Name): MCKAYLA BRIANN PRICE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11539 PARK WOODS CIR STE 603
ALPHARETTA GA
30005-2413
US

IV. Provider business mailing address

486 SUNSET PARK DR
SUWANEE GA
30024-5518
US

V. Phone/Fax

Practice location:
  • Phone: 678-615-7032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: