Individual
JESSICA NOEL KETTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
465 WINN WAY STE 221, DECATUR, GA 30030-1723
(888) 588-8995
Mailing address
4279 ROSWELL RD NE STE 208, STE 208 #179, ATLANTA, GA 30342-3705
(770) 404-6653
(770) 404-6654
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN255108
GA
Other
Enumeration date
10/13/2022
Last updated
04/22/2026
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