Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 053834 | GA |
N | 111NI0900X | Internist | 053834 | GA |
Y | 207RI0200X | Infectious Disease | 053834 | GA |
NPI | 1083650048 |
---|---|
Provider Name | Dr. Colleen Suzanne Kraft |
First Address | Decatur, GA 30033-2401 |
Second Address | Atlanta, GA 30322-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 28/09/2015 |