KATHLEEN MARIE SKLIVAGKOS NPI 1003448887

Nurse Practitioner (Family) in Alpharetta, GA

Individual Female Nurse Practitioner Family

About KATHLEEN SKLIVAGKOS

Kathleen Sklivagkos is a provider established in Alpharetta, Georgia and her medical specialization is nurse practitioner. The NPI number of Kathleen Sklivagkos is 1003448887 and was assigned on February 2020. The practitioner's primary taxonomy code is 363LF0000X with license number 222102 (GA). The provider is registered as an individual and her NPI record was last updated February 2020.

NPI

1003448887

Provider Name KATHLEEN MARIE SKLIVAGKOS
Provider Location Address2710 OLD MILTON PKWY STE 150 ALPHARETTA, GA 30009
Provider Mailing Address350 MONIVEA LN ROSWELL, GA 30075
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date02-10-2020
Last Update Date02-10-2020

Primary Taxonomy

Taxonomy Code363LF0000X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.222102
License StateGA
Taxonomy DescriptionDefinition to come…

Business Address

KATHLEEN MARIE SKLIVAGKOS
2710 OLD MILTON PKWY STE 150
ALPHARETTA, GA
ZIP 30009
Phone: (770) 274-9511

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Mailing Address

KATHLEEN MARIE SKLIVAGKOS
350 MONIVEA LN
ROSWELL, GA
ZIP 30075
Phone:

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.