Provider Demographics
NPI:1609213529
Name:FUSS, KATHRYN BRIANNE (MMS, PA-C)
Entity Type:Individual
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First Name:KATHRYN
Middle Name:BRIANNE
Last Name:FUSS
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Gender:F
Credentials:MMS, PA-C
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Mailing Address - Street 1:2110 POWERS FERRY RD SE STE 302
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5015
Mailing Address - Country:US
Mailing Address - Phone:470-419-4380
Mailing Address - Fax:470-298-7737
Practice Address - Street 1:371 E PACES FERRY RD NE STE 750
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2372
Practice Address - Country:US
Practice Address - Phone:470-419-4380
Practice Address - Fax:470-298-7737
Is Sole Proprietor?:No
Enumeration Date:2013-06-01
Last Update Date:2022-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NDPAC0697363A00000X
GA11000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant