Individual
MS. CARROLL MARIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
321 WASHINGTON COMMONS DR, EVANS, GA 30809-3170
(706) 231-5552
Mailing address
1801 MARYLAND AVE, AUGUSTA, GA 30904-5316
(706) 231-5552
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN113796
GA
172M00000X
Mechanotherapist
Primary
RN113796
GA
174H00000X
Health Educator
RN113796
GA
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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