Most Relevant Information
Provider Data
| NPI Number: | 1003448887 |
| Provider Name: | KATHLEEN MARIE SKLIVAGKOS |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 222102 |
Most Important Dates
| Enumeration Date: | 02/10/2020 |
| Last Updated: | 02/10/2020 |
Provider Practice Location
2710 OLD MILTON PKWY STE 150
ALPHARETTA
GA
300092223
Practice Location Phone/Fax
| Phone: | 7702749511 |
| Fax: |
Provider Mailing Location
350 MONIVEA LN
ROSWELL
GA
300752813
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |