Individual
MS. KELLY A GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
638 OLD HISTORIC US 441, SUITE B, DEMOREST, GA 30535
(770) 501-3830
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
GAA-NP001940
GA
Other
Enumeration date
12/22/2023
Last updated
01/04/2024
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