Provider Demographics
NPI:1053357160
Name:STONE, KATHLEEN M (CPNP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:STONE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:M
Other - Last Name:NISSLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2015 UPPERGATE DR
Mailing Address - Street 2:4TH FL
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-785-1741
Mailing Address - Fax:404-727-4455
Practice Address - Street 1:2015 UPPERGATE DR
Practice Address - Street 2:4TH FL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-785-1200
Practice Address - Fax:404-727-4455
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR065002207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology