MEDICARE: KATTIE PRICE

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	163W00000X	Registered Nurse	RN299874	GA

General Provider Information

NPI Number	:	1568159291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATTIE PRICE

Provider Business Mailing Address
First Line	:	800 GALLERIA PKWY SE UNIT 743
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6019
Country	:	US
Telephone Number	:	601-954-3322
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 GALLERIA PKWY SE UNIT 743
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6019
Country	:	US
Telephone Number	:	601-954-3322
Fax Number	:

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

Provider Enumeration Date	:	04/21/2023
Last Update Date	:	04/21/2023

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Directions to “ KATTIE PRICE ” Practice Location

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