Individual
KATLIN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 793-5000
Mailing address
921 TAMARISK PL, CANTON, GA 30114-1276
(706) 716-3748
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN255539
GA
363L00000X
Nurse Practitioner
Primary
RN255539
GA
Other
Enumeration date
04/08/2020
Last updated
02/10/2025
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