Healthcare Provider Details

I. General information

NPI: 1558764548
Provider Name (Legal Business Name): CAITLIN ELIZABETH KRIEGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CAITLIN ELIZABETH HURD

II. Dates (important events)

Enumeration Date: 10/03/2014
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680A EATONTON RD
MADISON GA
30650-4628
US

IV. Provider business mailing address

5400 GLENRIDGE DR UNIT 420337
ATLANTA GA
30342-7513
US

V. Phone/Fax

Practice location:
  • Phone: 404-282-5600
  • Fax: 404-282-5599
Mailing address:
  • Phone: 404-282-5600
  • Fax: 404-282-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7235
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: