Provider Demographics
NPI:1144782749
Name:DARNELL, KEELY (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:KEELY
Middle Name:
Last Name:DARNELL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SAMARITAN DR STE 306
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2396
Mailing Address - Country:US
Mailing Address - Phone:770-889-8302
Mailing Address - Fax:
Practice Address - Street 1:133 SAMARITAN DR STE 306
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2396
Practice Address - Country:US
Practice Address - Phone:770-889-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248505363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health