Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 146180 | GA |
NPI | 1003022310 |
---|---|
Provider Name | Karen Krechmery |
First Address | Atlanta, GA 30303-1401 |
Second Address | Riverdale, GA 30274-2615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 20/09/2007 |