Elizabeth Ann Kelly, FNP-BC
Individual provider Active NPI Nurse Practitioner · Arlington, GA
NPI 1831161090 · NPPES record last updated Sep 8, 2011
Key facts
- NPI
- 1831161090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN050989 (GA)
- Practice address
- 103 Re Jennings Ave SE
P.O. Drawer R
Arlington, GA 39813-8725 - Phone
- (229) 725-4251
- Fax
- (229) 725-2212
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN050989 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of Calhoun County | Past | Accepting new patients | |
| Calhoun Memorial Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN050989 | GA | |
| Nurse Practitioner | 363L00000X | RN050989 | GA | Yes |
Addresses
Primary practice location
103 Re Jennings Ave SE
P.O. Drawer R
Arlington, GA 39813-8725
Mailing address
55 Re Jennings Ave SE
P.O. Drawer R
Arlington, GA 39813-8722
Phone (229) 725-4272
Other providers in Arlington, GA
- Harris Pharmacy
- Hospital Authority of Calhoun County
- Hospital Authority of Calhoun County
- John Dallas, DMD, PC
- Marie W Jones
- Amy J Kocherla
- Cindy F Lee
- Demetria Cotton McDonald
- Miller Dental PC
- Angela Louie Muhammad
All providers in Arlington, GA · 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 Sep 8, 2011. 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.