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NPI Code Detail

MEDICARE: MRS. KAITLYN MARIE FREEMAN PA-C

MEDICARE: MRS. KAITLYN MARIE FREEMAN PA-C
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
1225X00000XOccupational TherapistOT006305GA
2363A00000XPhysician Assistant10860GA

General Provider Information

NPI Number : 1841739307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAITLYN MARIE FREEMAN PA-C
Provider Business Mailing Address
First Line : 135 GROGANS LAKE DR
Second Line :
City : ATLANTA
State : GA
Zip : 30350-3115
Country : US
Telephone Number : 320-290-5699
Fax Number :
Provider Business Practice Location Address
First Line : 993 JOHNSON FY RD NE STE F210
Second Line :
City : ATLANTA
State : GA
Zip : 30342-1688
Country : US
Telephone Number : 404-256-1727
Fax Number : 404-252-3591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2017
Last Update Date : 07/26/2023

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Directions to “ MRS. KAITLYN MARIE FREEMAN PA-C” Practice Location

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