Provider Demographics
NPI:1972119816
Name:SCHNELLINGER, KELLY GENE (DNP, PNP-PC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:GENE
Last Name:SCHNELLINGER
Suffix:
Gender:F
Credentials:DNP, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:2100 RIVERSIDE PKWY
Mailing Address - Street 2:STE 128, #131
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043
Mailing Address - Country:US
Mailing Address - Phone:404-909-5547
Mailing Address - Fax:
Practice Address - Street 1:2100 RIVERSIDE PKWY
Practice Address - Street 2:STE 128, #131
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043
Practice Address - Country:US
Practice Address - Phone:404-909-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA196869363LP0200X
GARN196869208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics