Organization
PRIDE PEDIATRICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY GENE SCHNELLINGER PNP-PC, DNP (CHIEF EXECUTIVE OFFICER)
(470) 236-6366
Entity
Organization
Contact information
Practice address
1442 SUGAR MAPLE WAY, LAWRENCEVILLE, GA 30043-5247
(470) 236-6366
Mailing address
2100 RIVERSIDE PKWY, STE 128, #131, LAWRENCEVILLE, GA 30043
(470) 236-6366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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