Healthcare Provider Details

I. General information

NPI: 1902752991
Provider Name (Legal Business Name): KATELYN MARIE GALBRAITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 INTERLOCHEN DR
PEACHTREE CITY GA
30269-3354
US

IV. Provider business mailing address

162 INTERLOCHEN DR
PEACHTREE CITY GA
30269-3354
US

V. Phone/Fax

Practice location:
  • Phone: 425-466-7274
  • Fax:
Mailing address:
  • Phone: 425-466-7274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9122287
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: