Healthcare Provider Details

I. General information

NPI: 1417861584
Provider Name (Legal Business Name): KELLI LYNN ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 10TH AVE
COLUMBUS GA
31901-3700
US

IV. Provider business mailing address

122 HIGHLAND VIEW DR
BIRMINGHAM AL
35242-6847
US

V. Phone/Fax

Practice location:
  • Phone: 706-989-4955
  • Fax: 888-571-6142
Mailing address:
  • Phone: 404-808-6059
  • Fax: 888-571-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-193925
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: