Individual
KELLY FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 838-8824
(770) 838-8563
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN209834
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN209834
GA
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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