| Doctor Name: | KATHLEEN ANN KELLY |
| NPI Number: | 1568576353 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN056832 |
| Business Practice Address: | 3931 Mundy Mill Rd Oakwood, GA - 305663413 |
| Business Phone Number: | 4043216111 |
| Business Fax Number: | |
| Mailing Address: | Po Box 220, TALMO |
| State: | GA |
| Postal Code: | 305750220 |
| Phone Number: | 7063677267 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | RN056832 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |