Individual
MARY KELLY HARBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 238-8012
(706) 238-8013
Mailing address
15 RIVERBEND DR SW, ROME, GA 30161-6005
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN155084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003105007A
—
GA
Enumeration date
06/12/2008
Last updated
08/20/2019
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