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General NPI Number Information
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NPI Number | 1558216390
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Entity Type | Individual
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Provider Name | RONNIE L MCKELLER RN
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Gender | Male
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 5688 WOODLAND GREENS RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-5885
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Country | US
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Telephone | 404-316-3631
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Fax | 404-891-6081
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Provider Business Mailing Address
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Address Line | 5688 WOODLAND GREENS RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-5885
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Country | US
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Telephone | 404-316-3631
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Fax | 404-891-6081
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN219163
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License Number State | GA
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