Individual
KELLY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
415 PENDLETON PL, VALDOSTA, GA 31602-2632
(229) 242-6868
Mailing address
415 PENDLETON PL, VALDOSTA, GA 31602-2632
(229) 242-6868
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
236257
GA
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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