Individual
DENNA KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2202 MARSHALLVILLE RD, PERRY, GA 31069-9517
(478) 722-9399
Mailing address
2202 MARSHALLVILLE RD, PERRY, GA 31069-9517
(785) 350-3111
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024181501
VA
363LG0600X
Gerontology Nurse Practitioner
0024181501
VA
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
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