Individual
DAVID KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
101 FORNUM DR, GROVETOWN, GA 30813-2697
(706) 434-3500
Mailing address
101 FORNUM DR, GROVETOWN, GA 30813-2697
(706) 434-3500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN201485
GA
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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