KAITLIN DIVINNIE AGPCNP NPI 1174997647

NPI Information

NPI: 1174997647
Provider Name: KAITLIN DIVINNIE, AGPCNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
1365 CLIFTON RD NE BLDG B
ATLANTA, GA
ZIP 30322
Phone: (404) 778-3184
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Kaitlin Divinnie, AGPCNP is a primary care nurse practitioner in Atlanta, GA with 9 years of experience. Kaitlin Divinnie, AGPCNP NPI is 1174997647. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2015

The provider's business location address is:

1365 CLIFTON RD NE BLDG B
ATLANTA, GA
ZIP 30322-736
Phone: (404) 778-3184

The NPI 1174997647 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/21/2015 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		RN224677	GEORGIA	No
2	363LP2300X	Nurse Practitioner	Primary Care	RN224677	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1174997647	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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