Kelli Marie Kushinka, NP

Individual provider Active NPI Pediatric Nurse Practitioner · Warner Robins, GA

NPI 1124687348 · NPPES record last updated Jun 11, 2019

Key facts

NPI
1124687348
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
RN250344 (GA)
Practice address
116 S Houston Rd
Warner Robins, GA 31088-3904
Phone
(478) 923-0131
Fax
(478) 922-6530
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN250344GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Medical Assoc., LLC Past Accepting new patients
Pediatric First, PC Past Accepting new patients
Pediatric Care After Hours Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN250344 GA Yes

Addresses

Primary practice location

116 S Houston Rd
Warner Robins, GA 31088-3904

Mailing address

PO Box 8818
Warner Robins, GA 31095-8818
Phone (478) 923-0131

Other practice location 1

1275 S Houston Lake Rd Ste 1&2
Warner Robins, GA 31088-0746
Phone (478) 987-1100

Other identifiers

IdentifierTypeStateIssuer
RN250344OtherGARN
201913531OtherGANP CERTIFICATION

Other providers in Warner Robins, GA

All providers in Warner Robins, GA · Pediatric Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.