Healthcare Provider Details

I. General information

NPI: 1225548449
Provider Name (Legal Business Name): KELLY MICHELLE DAYHOFF PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MICHELLE COLEMAN BSN, RN, CEN

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

6524 SAND LAKE SOUND RD UNIT 3102
ORLANDO FL
32819-7613
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5478
  • Fax:
Mailing address:
  • Phone: 561-262-8137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8657
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number8657
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: