Healthcare Provider Details

I. General information

NPI: 1750202529
Provider Name (Legal Business Name): KATHARINE HOULIHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NORTHSIDE FORSYTH DR STE 240
CUMMING GA
30041-6017
US

IV. Provider business mailing address

5205 VILLAGE GREEN TRCE
ROSWELL GA
30075-7651
US

V. Phone/Fax

Practice location:
  • Phone: 770-844-0877
  • Fax:
Mailing address:
  • Phone: 404-906-8629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP316287
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: