Healthcare Provider Details

I. General information

NPI: 1598373805
Provider Name (Legal Business Name): ISABEL KATHRYN QUITIQUIT-FIGUEROS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 QUEENS WALK NE
ATLANTA GA
30345-2165
US

IV. Provider business mailing address

3144 QUEENS WALK NE
ATLANTA GA
30345-2165
US

V. Phone/Fax

Practice location:
  • Phone: 678-232-2363
  • Fax:
Mailing address:
  • Phone: 678-232-2363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN152554
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: