Provider Demographics
NPI:1205371879
Name:KINLEY, ANNA KATHERINE (MSN, APRN, CPNP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHERINE
Last Name:KINLEY
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:KATHERINE
Other - Last Name:BERRYHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3383 CASTLEBERRY VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2386
Mailing Address - Country:US
Mailing Address - Phone:205-901-2788
Mailing Address - Fax:
Practice Address - Street 1:75 ELLIOTT RD STE 200
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-8904
Practice Address - Country:US
Practice Address - Phone:706-216-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN242379363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics