MEDICARE: MS. KATHERINE LEIGH KEY R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN101996	GA

General Provider Information

NPI Number	:	1104046713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE LEIGH KEY R.N.

Provider Business Mailing Address
First Line	:	139 HENRY PKWY
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-6636
Country	:	US
Telephone Number	:	770-898-7400
Fax Number	:	770-898-7412

Provider Business Practice Location Address
First Line	:	139 HENRY PKWY
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-6636
Country	:	US
Telephone Number	:	770-898-7400
Fax Number	:	770-898-7412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/08/2007

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