Provider Demographics
NPI:1831315431
Name:WEEKS, KEELA K (NP)
Entity type:Individual
Prefix:
First Name:KEELA
Middle Name:K
Last Name:WEEKS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 CRABAPPLE RD
Mailing Address - Street 2:SUITE 104B
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2489
Mailing Address - Country:US
Mailing Address - Phone:770-645-0017
Mailing Address - Fax:770-645-0224
Practice Address - Street 1:11050 CRABAPPLE ROAD
Practice Address - Street 2:SUITE104 B
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075
Practice Address - Country:US
Practice Address - Phone:770-645-0017
Practice Address - Fax:770-645-0224
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA155393363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I500272Medicare UPIN