Provider Demographics
NPI:1558812024
Name:KARIMI, GABRIELLA CONCETTA (PA-C)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:CONCETTA
Last Name:KARIMI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:GABRIELLA
Other - Middle Name:CONCETTA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1924 PIEDMONT RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4117
Mailing Address - Country:US
Mailing Address - Phone:404-881-0966
Mailing Address - Fax:404-874-5902
Practice Address - Street 1:1924 PIEDMONT RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4117
Practice Address - Country:US
Practice Address - Phone:404-881-0966
Practice Address - Fax:404-874-5902
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8169363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant