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Individual

MRS. KELLY M DOUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP-BC

Contact information

Practice address
2122 MANCHESTER EXPRESSWAY, COLUMBUS, GA 31904
(706) 320-2773
(706) 596-4226
Mailing address
2300 MANCHESTER EXPY STE 2001A, COLUMBUS, GA 31904-6802
(706) 320-3126
(706) 320-3054

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN226465
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003129046E
GA
05
167215
AL
Enumeration date
05/20/2011
Last updated
08/01/2024
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