Kelly Lynn Anderson, ATC
Individual provider Active NPI Athletic Trainer · Duluth, GA
NPI 1831639293 · NPPES record last updated Mar 6, 2017
Key facts
- NPI
- 1831639293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 060802416 (GA)
- Practice address
- 3855 Pleasant Hill Rd
Suite 130
Duluth, GA 30096-1407 - Phone
- (678) 312-7880
- Fax
- (678) 312-7890
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060802416 | GA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 060802416 | GA | Yes |
Addresses
Primary practice location
3855 Pleasant Hill Rd
Suite 130
Duluth, GA 30096-1407
Mailing address
3855 Pleasant Hill Rd
Suite 130
Duluth, GA 30096-1407
Phone (678) 312-7880
Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2017. 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.