Provider Demographics
NPI:1568863215
Name:DRUCKER, KATHRYNE BROOKE (NP-C)
Entity Type:Individual
Prefix:
First Name:KATHRYNE
Middle Name:BROOKE
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8895 CARROLL MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2079
Mailing Address - Country:US
Mailing Address - Phone:678-641-7687
Mailing Address - Fax:
Practice Address - Street 1:3225 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-1266
Practice Address - Country:US
Practice Address - Phone:678-560-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN192005363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily