Individual
KATHERINE A KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1800 TREE LN STE 300, SNELLVILLE, GA 30078-6794
(770) 972-6464
(770) 978-4819
Mailing address
1800 TREE LN STE 300, SNELLVILLE, GA 30078-6794
(770) 972-6464
(770) 978-4819
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002027
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003152721A
—
GA
Enumeration date
05/02/2006
Last updated
07/21/2022
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