Healthcare Provider Details

I. General information

NPI: 1245863802
Provider Name (Legal Business Name): KYLEE BATTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 HARTLEY BRIDGE RD
MACON GA
31216-5641
US

IV. Provider business mailing address

1311 BOY SCOUT RD
BYRON GA
31008-5035
US

V. Phone/Fax

Practice location:
  • Phone: 478-788-1015
  • Fax:
Mailing address:
  • Phone: 478-396-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH026570
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: