Individual
KELLIE THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 GOLDEN WAY, WATKINSVILLE, GA 30677-7712
(706) 612-9401
Mailing address
1150 GOLDEN WAY, WATKINSVILLE, GA 30677-7712
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP300595
GA
Other
Enumeration date
07/02/2024
Last updated
10/28/2025
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