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General NPI Number Information
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NPI Number | 1598482432
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Entity Type | Individual
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Provider Name | CAROLINE AVETT
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Gender | Female
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 4800 OLDE TOWNE PKWY STE 400
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City | MARIETTA
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State | GA
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Zip | 30068-4424
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Country | US
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Telephone | 678-718-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 W PEACHTREE ST NW
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City | ATLANTA
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State | GA
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Zip | 30309-3609
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Country | US
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Telephone | 404-892-2131
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12143
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License Number State | GA
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