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General NPI Number Information
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NPI Number | 1619884954
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Entity Type | Organization
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Legal Business Name | EXCEPTIONAL ACE LLC
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 933 REDA CT
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City | MCDONOUGH
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State | GA
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Zip | 30253-1906
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Country | US
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Telephone | 877-223-9272
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 WOODMONT LN NW STE 2636
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRECIOUS KELLY
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Credential |
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Telephone | 877-223-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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