Provider Demographics
NPI:1184094625
Name:ROSS, KIMMARIE NICOLA (DNP)
Entity type:Individual
Prefix:MRS
First Name:KIMMARIE
Middle Name:NICOLA
Last Name:ROSS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:KIMMARIE
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:80 GILMER ST. SE
Mailing Address - Street 2:6TH FLOOR GI
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:646-431-7223
Mailing Address - Fax:
Practice Address - Street 1:80 GILMER ST. SE
Practice Address - Street 2:6TH FLOOR GI
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-27
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily