Provider Demographics
NPI:1194250233
Name:DANG, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:DANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NASH LEE DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-7641
Mailing Address - Country:US
Mailing Address - Phone:404-702-3409
Mailing Address - Fax:404-581-5637
Practice Address - Street 1:3675 CRESTWOOD PKWY NW STE 400
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5054
Practice Address - Country:US
Practice Address - Phone:404-702-3409
Practice Address - Fax:404-581-5637
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care