Individual
KELLY ROSE PERONTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
401 DOUBLETRACE LN, PEACHTREE CITY, GA 30269-1822
(770) 344-7821
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN199128
GA
390200000X
Student in an Organized Health Care Education/Training Program
RN199128
GA
Other
Enumeration date
12/27/2016
Last updated
10/09/2025
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