Individual
JEFFRREY CORNELIUS SHELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
504 GILL RD, KINGSTON, GA 30145-1334
(770) 769-8881
Mailing address
504 GILL RD, KINGSTON, GA 30145-1334
(770) 769-8881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN217906
GA
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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