Individual
FELICITY MARUM KERIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1265 HIGHWAY 54 W STE 102, FAYETTEVILLE, GA 30214
(770) 496-1900
Mailing address
900 CIRCLE 75 PKWY SE STE 1700, ATLANTA, GA 30339-3087
(770) 953-6929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7367
GA
363A00000X
Physician Assistant
PA0004753
CO
Other
Enumeration date
10/02/2014
Last updated
10/04/2019
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