Provider Demographics
NPI:1255881363
Name:NOBLES, MARY KATHRYN (CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:NOBLES
Suffix:
Gender:F
Credentials:CNP
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Other - Credentials:
Mailing Address - Street 1:NORTHSIDE HOSPITAL MANAGED CARE DEPARTMENT
Mailing Address - Street 2:1000 JOHNSON FERRY RD NE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3035
Mailing Address - Country:US
Mailing Address - Phone:404-300-2476
Mailing Address - Fax:404-250-8010
Practice Address - Street 1:5670 PEACHTREE DUNWOODY
Practice Address - Street 2:880
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1699
Practice Address - Country:US
Practice Address - Phone:404-256-2525
Practice Address - Fax:404-845-4720
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN176572363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner