Provider Demographics
NPI:1528702685
Name:DUKE, KATELYN ALAYNE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:ALAYNE
Last Name:DUKE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 DIAMOND RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-7127
Mailing Address - Country:US
Mailing Address - Phone:404-723-2562
Mailing Address - Fax:
Practice Address - Street 1:1245 NOAH DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-8721
Practice Address - Country:US
Practice Address - Phone:706-253-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN272530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily