Provider Demographics
NPI:1407079924
Name:KONTER, ROSLYN POLLARD (CPNP)
Entity Type:Individual
Prefix:
First Name:ROSLYN
Middle Name:POLLARD
Last Name:KONTER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LAKE HEARN DR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1523
Mailing Address - Country:US
Mailing Address - Phone:404-256-3178
Mailing Address - Fax:
Practice Address - Street 1:1100 LAKE HEARN DR NE
Practice Address - Street 2:STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1523
Practice Address - Country:US
Practice Address - Phone:404-256-3175
Practice Address - Fax:404-256-3583
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN121158NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics