Individual
KELLI KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4 LIVE OAK CT, MOULTRIE, GA 31768-6783
(229) 785-2400
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 891-9131
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN244596
GA
Other
Enumeration date
04/13/2021
Last updated
07/28/2023
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