Healthcare Provider Details

I. General information

NPI: 1639840192
Provider Name (Legal Business Name): KATHLEEN ROSELENA MONEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BROOKSTONE CENTRE PKWY STE B
COLUMBUS GA
31904-2990
US

IV. Provider business mailing address

100 BROOKSTONE CENTRE PKWY STE B
COLUMBUS GA
31904-2990
US

V. Phone/Fax

Practice location:
  • Phone: 706-341-3797
  • Fax: 706-268-9758
Mailing address:
  • Phone: 706-341-3797
  • Fax: 706-268-9758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number10738
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10738
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: