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General NPI Number Information
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NPI Number | 1831719608
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Entity Type | Individual
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Provider Name | BROOKE KAITLIN ATTAWAY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 601 FERNCREST DR STE 2
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1892
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Country | US
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Telephone | 478-412-2880
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Fax | 478-412-2881
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Provider Business Mailing Address
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Address Line | 524 SPARTA RD
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City | SANDERSVILLE
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State | GA
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Zip | 31082-1376
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Country | US
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Telephone | 478-412-2880
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Fax | 478-412-2881
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN239637
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP239637
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License Number State | GA
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