Provider Demographics
NPI:1275054645
Name:QUINLEY, KATHERINE NICOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:NICOLE
Last Name:QUINLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 52226
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30355-0226
Mailing Address - Country:US
Mailing Address - Phone:404-816-7900
Mailing Address - Fax:404-816-7929
Practice Address - Street 1:3131 MAPLE DR NE STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2515
Practice Address - Country:US
Practice Address - Phone:404-816-7900
Practice Address - Fax:404-816-7929
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2018-03-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical