Individual
KELLY ASHTON FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
861 S 1ST ST, JESUP, GA 31545-0210
(912) 810-8801
Mailing address
109 AMETHYST DR, BLOOMINGDALE, GA 31302-9776
(302) 932-0127
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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