Individual
KATHRYN JOAN SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1240 EAGLES LANDING PKWY, SUITE 300, STOCKBRIDGE, GA 30281
(770) 506-4350
(770) 506-9860
Mailing address
3100 INTERSTATE NORTH CIR SE STE 50, ATLANTA, GA 30339-2227
(770) 953-6929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154965700A
—
GA
05
—
154965700B
—
GA
01
—
N270018
WELLCARE MEDICAID
GA
01
—
P00083326
RAILROAD MEDICARE
GA
Enumeration date
07/28/2005
Last updated
04/30/2025
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