Provider Demographics
NPI:1649338856
Name:STRICKLAND, KELLEIGH JEAN (NP)
Entity type:Individual
Prefix:
First Name:KELLEIGH
Middle Name:JEAN
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 N MILLEDGE AVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30601-3803
Mailing Address - Country:US
Mailing Address - Phone:770-965-2699
Mailing Address - Fax:
Practice Address - Street 1:420 W 1500 S STE 201
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-7434
Practice Address - Country:US
Practice Address - Phone:844-209-5258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR45240363LF0000X, 363LF0000X
MNCNP5610363LF0000X
GARN146690363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily