1780579235 NPI number — KATHRYN ANNE JENKINS FERREIRA CCC-A, AUD

Table of content: KATHRYN ANNE JENKINS FERREIRA CCC-A, AUD (NPI 1780579235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780579235 NPI number — KATHRYN ANNE JENKINS FERREIRA CCC-A, AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERREIRA
Provider First Name:
KATHRYN
Provider Middle Name:
ANNE JENKINS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CCC-A, AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JENKINS
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1780579235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13280 WARRENSVILLE CV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30004-7634
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-416-0799
Provider Business Mailing Address Fax Number:
770-292-3046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3180 NORTH POINT PKWY
Provider Second Line Business Practice Location Address:
BLDG 500, SUITE 512
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30005-4569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-292-3045
Provider Business Practice Location Address Fax Number:
770-292-3046
Provider Enumeration Date:
06/12/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AUD004459 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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