# MRS. KELLY O'KEEFE-WATSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1174835334
- **Gender:** F
- **Credential:** P.A.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 5849 | GA | Yes |
| 363A00000X | Physician Assistant | PA.712 | AL | — |

## Other

- **Enumeration date:** 07/05/2010
- **Last updated:** 04/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003105013 | — | GA |
| 05 | — | 170095 | — | AL |
| 01 | — | 20297I6144 | MEDICARE PTAN | GA |