# KELLY C. STEGALL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1801116942
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN181599 | GA | Yes |

## Other

- **Enumeration date:** 06/10/2010
- **Last updated:** 08/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01368785 | AMERIGROUP | GA |
| 05 | — | 839184162A | — | GA |
| 05 | — | 839184162B | — | GA |
| 05 | — | NP1638 | — | SC |
| 01 | — | P00869909 | RR MEDICARE | GA |