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General NPI Number Information
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NPI Number | 1972993137
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Entity Type | Individual
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Provider Name | KATHRON MAE JANKIEWICZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 480 N MAIN ST
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City | ALPHARETTA
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State | GA
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Zip | 30009-8385
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Country | US
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Telephone | 678-619-1974
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Fax | 678-619-1975
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Provider Business Mailing Address
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Address Line | 480 N MAIN ST
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City | ALPHARETTA
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State | GA
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Zip | 30009-8385
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Country | US
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Telephone | 678-619-1974
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Fax | 678-619-1975
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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 | RN216253
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License Number State | GA
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