Individual
KELLY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 259-4435
(706) 226-2283
Mailing address
1419 CHATTANOOGA AVE, SUITE 4, DALTON, GA 30720-2642
(706) 259-4435
(706) 226-2283
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN117855
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
30340
TN
367500000X
Certified Registered Nurse Anesthetist
RN117855
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00846425V
—
GA
Enumeration date
10/02/2006
Last updated
10/21/2021
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