Individual
KELLY BOYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
124 MEMORIAL DR, JESUP, GA 31545-0101
(912) 427-4413
Mailing address
290 WHITE OAK DRIVE NE, LUDOWICI, GA 31316
(912) 294-4479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207026
GA
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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