Kaley Adams, PNP
Individual provider Active NPI Pediatric Nurse Practitioner · Moultrie, GA
NPI 1629614060 · NPPES record last updated Apr 14, 2023
Key facts
- NPI
- 1629614060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- RN228175 (GA)
- Practice address
- 760 26TH Ave SE
Moultrie, GA 31768-6799 - Phone
- (229) 985-1457
- Fax
- (229) 890-9430
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN228175 | GA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Pediatric Center LLC | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| The Pediatric Center LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | RN228175 | GA | Yes |
Addresses
Primary practice location
760 26TH Ave SE
Moultrie, GA 31768-6799
Mailing address
760 26TH Ave SE
Moultrie, GA 31768-6799
Phone (229) 985-1457
Other providers in Moultrie, GA
- Jack Loran Adams III
- Adcock Center for Women'S Health PA
- Toluwani Olugbenga Adebisi
- Anthony Adebayo Adetomiwa
- Alfred Ernest Aguero
- Amal Akhtar
All providers in Moultrie, GA · Pediatric Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.