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General NPI Number Information
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NPI Number | 1649719915
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Entity Type | Individual
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Provider Name | KELLY BOARD APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/19/2017
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 1055 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-5557
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Provider Business Mailing Address
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Address Line | PO BOX 211699
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City | EAGAN
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State | MN
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Zip | 55121-3699
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209028496
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | CAPN.0101629
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 303204
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1102491
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | GAA-NP003047
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0024194779
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 37319
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0033314
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704272053
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 244045
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License Number State | LA
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Taxonomy #11
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9482729
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License Number State | FL
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Taxonomy #12
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5018989
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License Number State | NC
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Taxonomy #13
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 29709
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License Number State | SC
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