Healthcare Provider Details

I. General information

NPI: 1982107488
Provider Name (Legal Business Name): KATRINA ANNE MAAKARON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATRINA ANNE MILLER

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5670 PEACHTREE DUNWOODY RD STE 1100
SANDY SPRINGS GA
30342-4795
US

IV. Provider business mailing address

5670 PEACHTREE DUNWOODY RD STE 1100
SANDY SPRINGS GA
30342-4795
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-2300
  • Fax: 404-851-2014
Mailing address:
  • Phone: 404-851-2300
  • Fax: 404-851-2014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13045
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: