Shelley, Kathryn Joan
Shelley, Kathryn Joan is an individual health care provider with primary practice located at 1240 Eagles Landing Pkwy Suite 300, Stockbridge GA 30281. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Shelley, Kathryn Joan can be contacted via phone (770) 506-4350.Contact Information
Primary practice address
1240 Eagles Landing Pkwy Suite 300
Stockbridge GA 30281
Phone: (770) 506-4350
Fax: (770) 506-9860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 004203 | Georgia |
Profile Details
| NPI number | 1215937578 |
|---|---|
| LBN Legal business name | Shelley, Kathryn Joan |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jun 3rd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215937578 | NPPES |
| Georgia | MEDICAID | 154965700B | |
| Georgia | Other | P00083326 | |
| Georgia | Other | N270018 | |
| Georgia | MEDICAID | 154965700A |
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