Individual
KELLIE DUCKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 794-0477
(770) 794-3108
Mailing address
1825 HICKORY CREEK CT NW, ACWORTH, GA 30102-6416
(770) 823-2157
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN207654
GA
Other
Enumeration date
01/26/2016
Last updated
08/28/2019
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