Individual
KELLY PERDOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3369 BUFORD HWY NE STE 810, BROOKHAVEN, GA 30329-3722
(404) 321-4692
(404) 321-4366
Mailing address
3369 BUFORD HWY, STE 810, BROOKHAVEN, GA 30329
(404) 321-4692
(404) 321-4366
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN222479
GA
Other
Enumeration date
12/21/2016
Last updated
07/21/2022
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