Healthcare Provider Details

I. General information

NPI: 1578022968
Provider Name (Legal Business Name): RACHEL KRIEGER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 05/26/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WELLSTAR KENNESTONE HOSPITAL 115 CHERRY STREET
MARIETTA GA
30060
US

IV. Provider business mailing address

477 WILMER ST NE UNIT 2400
ATLANTA GA
30308-3017
US

V. Phone/Fax

Practice location:
  • Phone: 770-793-5700
  • Fax:
Mailing address:
  • Phone: 845-269-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number91316
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: