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Individual

KATHRYN MAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
(470) 644-1119
Mailing address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
(470) 644-1119

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN316420
GA
367500000X
Certified Registered Nurse Anesthetist
RN558712
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103092798
PA
Enumeration date
09/21/2011
Last updated
07/12/2023
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