Individual
KELLY RENAE GRUMMER-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
39 KENT RD STE 5, TIFTON, GA 31794-1697
(229) 353-7337
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
(229) 353-6060
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
545382
CA
163WL0100X
Lactation Consultant (Registered Nurse)
RN180155
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
NP180155
GA
Other
Enumeration date
04/08/2013
Last updated
10/10/2025
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