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General NPI Number Information
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NPI Number | 1134053358
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Entity Type | Individual
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Provider Name | DELIA KE RN, BSN
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Gender | Female
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 4505 PEACHTREE INDUSTRIAL BLVD STE K
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City | BERKELEY LAKE
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State | GA
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Zip | 30092-3099
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Country | US
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Telephone | 678-205-2010
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Fax | 678-205-2020
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Provider Business Mailing Address
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Address Line | 8590 ROYAL TROON DR
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City | DULUTH
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State | GA
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Zip | 30097-1683
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Country | US
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Telephone | 678-227-9414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN076700
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License Number State | GA
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