Provider Demographics
NPI:1629435185
Name:GIULIANO, KERI R (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KERI
Middle Name:R
Last Name:GIULIANO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1071
Mailing Address - Country:US
Mailing Address - Phone:770-590-8311
Mailing Address - Fax:770-590-8313
Practice Address - Street 1:790 CHURCH ST NE STE 335
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8957
Practice Address - Country:US
Practice Address - Phone:770-590-8311
Practice Address - Fax:770-590-8313
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA159908363LF0000X
GARN159908363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003196007AMedicaid
GA003196007EMedicaid
GA003196007BMedicaid
GA20250I2103OtherMEDICARE PTAN