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NPI Code Detail

MEDICARE: MRS. KIMBERLY STRAUB BRADLYN PA-C

MEDICARE: MRS. KIMBERLY STRAUB BRADLYN 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
1363A00000XPhysician Assistant10468GA

General Provider Information

NPI Number : 1902482623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY STRAUB BRADLYN PA-C
Provider Business Mailing Address
First Line : 2220 NORTH DRUID HILLS ROAD NE
Second Line : CHILDREN'S HEART CENTER
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-421-9784
Fax Number :
Provider Business Practice Location Address
First Line : 2220 NORTH DRUID HILLS ROAD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3117
Country : US
Telephone Number : 404-256-2593
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 03/26/2026

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Directions to “ MRS. KIMBERLY STRAUB BRADLYN PA-C” Practice Location

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