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General NPI Number Information
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NPI Number | 1730660093
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Entity Type | Individual
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Provider Name | VIRGINIA TITTLE KEE NNP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 11 UPPER RIVERDALE RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2615
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Country | US
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Telephone | 770-991-8297
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Fax | 770-909-2088
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Provider Business Mailing Address
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Address Line | 16 WRIGHTSBURG CT
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City | SENOIA
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State | GA
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Zip | 30276-3411
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Country | US
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Telephone | 770-318-3361
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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 | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | RN145053
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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