Individual
HAILEY CHRISTINE WETTA PACHCIARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(404) 501-1000
Mailing address
2701 N DECATUR RD, DECATUR, GA 30033-5918
(404) 501-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9159
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159006
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
01
—
9159
GEORGIA COMPOSITE MEDICAL BOARD PA LICENSE
GA
Enumeration date
02/19/2019
Last updated
08/26/2022
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