Individual
MRS. KELSEY IRENE FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1605 MULKEY RD, SUITE 220, AUSTELL, GA 30106-1127
(470) 956-3760
Mailing address
3149 DUNN ST SE, SMYRNA, GA 30080-4413
(760) 214-4060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN211782
GA
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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