Provider Demographics
NPI:1427202068
Name:BROWN, KATHERINE LEIGH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CHURCHILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-4503
Mailing Address - Country:US
Mailing Address - Phone:678-977-1126
Mailing Address - Fax:
Practice Address - Street 1:5887 GLENRIDGE DR
Practice Address - Street 2:SUITE 140
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5574
Practice Address - Country:US
Practice Address - Phone:678-705-7341
Practice Address - Fax:678-973-0578
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant