Individual
MRS. KELLY BRUMBELOW NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, BC
Contact information
Practice address
145 N MEDICAL PKWY, WOODSTOCK, GA 30189
(770) 592-3000
(770) 999-2650
Mailing address
145 N MEDICAL PKWY, WOODSTOCK, GA 30189-7031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
112048
GA
363L00000X
Nurse Practitioner
Primary
RN112048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316257111A
—
GA
Enumeration date
07/30/2006
Last updated
04/19/2023
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