Kelly Perdomo, NP-C
Nurse Practitioner, Family in Brookhaven, GA. Individual provider (NPI-1).
NPI number1669917985
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1669917985
- Entity type
- Individual (NPI-1)
- Name
- Kelly Perdomo
- Credential
- NP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 21, 2016
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN222479 | GA | Yes |
Other names
- Kelly Vanessa Perdomo (Professional Name)
Practice location
3369 Buford Hwy Ne Ste 810Brookhaven, GA 30329-3722
Phone 404-321-4692 · Fax 404-321-4366
Mailing address
3369 Buford HwySte 810
Brookhaven, GA 30329
Phone 404-321-4692 · Fax 404-321-4366
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