Healthcare Provider Details

I. General information

NPI: 1144215732
Provider Name (Legal Business Name): KATHY SCHLEIER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 CHATTANOOGA AVE SUITE 1
DALTON GA
30720-2671
US

IV. Provider business mailing address

1575 CHATTANOOGA AVE SUITE 1
DALTON GA
30720-2671
US

V. Phone/Fax

Practice location:
  • Phone: 706-876-2130
  • Fax: 706-876-2168
Mailing address:
  • Phone: 706-876-2130
  • Fax: 706-876-2168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN054468
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: