Individual
KAELIN JENYSE GATEWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3001 S COBB DR SE, SMYRNA, GA 30080-7874
(404) 296-7133
(770) 432-9139
Mailing address
525 HERMAN AVE, BOWLING GREEN, KY 42104-8577
(770) 527-5487
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN233748
GA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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