MEDICARE: MS. KATHRYN RICHTER HART PNP

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	208000000X	Pediatrics Physician	RN236600	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	059227895	OTHER	GA	DRIVER'S LICENSE

General Provider Information

NPI Number	:	1548772999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN RICHTER HART PNP

Provider Business Mailing Address
First Line	:	6095 BARFIELD RD STE 200
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4408
Country	:	US
Telephone Number	:	404-256-2688
Fax Number	:	770-685-7114

Provider Business Practice Location Address
First Line	:	6095 BARFIELD RD STE 200
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4408
Country	:	US
Telephone Number	:	404-256-2688
Fax Number	:	770-685-7114

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

Provider Enumeration Date	:	10/25/2017
Last Update Date	:	10/31/2025

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