Healthcare Provider Details

I. General information

NPI: 1669269197
Provider Name (Legal Business Name): KATHERINE NICOLE BRIGNONI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 TOWER RD NE STE 300
MARIETTA GA
30060-9408
US

IV. Provider business mailing address

793 SAWYER RD
MARIETTA GA
30062-2222
US

V. Phone/Fax

Practice location:
  • Phone: 770-427-2457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN307111
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: