Provider Demographics
NPI:1770108805
Name:GREEFF, KELSEY LYNNE (PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNNE
Last Name:GREEFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 TARVA PL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7401
Mailing Address - Country:US
Mailing Address - Phone:678-462-3882
Mailing Address - Fax:
Practice Address - Street 1:3400C OLD MILTON PKWY STE 270
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4438
Practice Address - Country:US
Practice Address - Phone:770-442-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical