Individual
KELLY MARIE MCCORKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(571) 801-0731
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(571) 801-0731
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86146828
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
TX
Other
Enumeration date
10/03/2023
Last updated
03/06/2026
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