Individual
RAELYNN MARIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1955 BELLS FERRY RD APT 4322, MARIETTA, GA 30066-7014
(404) 254-7464
Mailing address
1955 BELLS FERRY RD APT 4322, MARIETTA, GA 30066-7014
(404) 254-7464
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN095148
GA
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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