Individual
KELLEY SUE WHARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
(770) 921-6900
(770) 921-6313
Mailing address
4120 FIVE FORKS TRICKUM RD SW, SUITE 105, LILBURN, GA 30047-3130
(770) 921-6900
(770) 921-6313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN113675
GA
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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