KATIA FAYOLA OUTLAW NPI 1720495021

NPI Information

NPI: 1720495021
Provider Name: KATIA FAYOLA OUTLAW
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
550 PEACHTREE ST NE STE 1600
ATLANTA, GA
ZIP 30308
Phone: (404) 298-8998
Get Directions

Katia Fayola Outlaw is a family nurse practitioner in Atlanta, GA. Katia Fayola Outlaw NPI is 1720495021. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

550 PEACHTREE ST NE STE 1600
ATLANTA, GA
ZIP 30308-246
Phone: (404) 298-8998

The NPI 1720495021 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 7/18/2014 and was last updated on 3/6/2020.

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	163W00000X	Registered Nurse		4704254995	MICHIGAN	No
2	363LF0000X	Nurse Practitioner	Family	4704254995	MICHIGAN	No
3	363LF0000X	Nurse Practitioner	Family	281863	NORTH CAROLINA	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	NP3723	MEDICAID	SOUTH CAROLINA
2	1720495021	MEDICAID	NORTH CAROLINA

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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