=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174969471
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN KRISTINE DAWSON AA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2013
-----------------------------------------------------
Last Update Date | 05/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1740 HUDSON BRIDGE RD SUITE 1218
-----------------------------------------------------
City | STOCKBRIDGE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30281-6331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-604-1053
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 714 PEACHTREE HILLS CIR NE APT 714
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30305-4246
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-951-9076
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367H00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiologist Assistant
-----------------------------------------------------
License Number | 6761
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------