Provider Demographics
NPI:1588615728
Name:TURCOTTE, KELLY (RN, WHNP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:TURCOTTE
Suffix:
Gender:F
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 TREE LANE RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6782
Mailing Address - Country:US
Mailing Address - Phone:770-972-0330
Mailing Address - Fax:770-985-2683
Practice Address - Street 1:1700 TREE LANE RD
Practice Address - Street 2:SUITE 290
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6782
Practice Address - Country:US
Practice Address - Phone:770-972-0330
Practice Address - Fax:770-985-2683
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN169971363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN169971OtherPROFESSIONAL NURSE LICENS