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Individual
KELLI MARIE KUSHINKA
Active
Individual
KELLI MARIE KUSHINKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN250344
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201913531
NP CERTIFICATION
GA
01
—
RN250344
RN
GA
Enumeration date
06/11/2019
Last updated
06/11/2019
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