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General NPI Number Information
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NPI Number | 1164071726
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Entity Type | Individual
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Provider Name | KATHERINE ZOPPOTH KIRSON NP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1810 MULKEY RD STE 201
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City | AUSTELL
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State | GA
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Zip | 30106-1150
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Country | US
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Telephone | 770-819-9262
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Fax | 770-819-0597
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Provider Business Mailing Address
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Address Line | 4581 S COBB DR SE STE 100
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City | SMYRNA
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State | GA
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Zip | 30080-6906
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Country | US
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Telephone | 770-801-5000
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Fax | 770-435-6690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 233104
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN290707
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License Number State | GA
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