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NPI Code Detail

MEDICARE: MS. RACHEL JORDAN KELLEY FNP-BC

MEDICARE: MS. RACHEL JORDAN KELLEY FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN258590GA
2261QU0200XUrgent Care Clinic/Center258590GA

General Provider Information

NPI Number : 1710765284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RACHEL JORDAN KELLEY FNP-BC
Provider Business Mailing Address
First Line : 5416 N PEACHTREE RD
Second Line :
City : DUNWOODY
State : GA
Zip : 30338-3134
Country : US
Telephone Number : 770-846-6233
Fax Number :
Provider Business Practice Location Address
First Line : 173 BOULEVARD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1468
Country : US
Telephone Number : 404-658-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2023
Last Update Date : 01/08/2026

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