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NPI Code Detail

MEDICARE: MRS. KELLI LYNN NOBLE MSN, NP-C

MEDICARE: MRS. KELLI LYNN NOBLE MSN, NP-C
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 Practitioner16842TN
2363LF0000XFamily Nurse PractitionerRN292239GA

General Provider Information

NPI Number : 1942556063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLI LYNN NOBLE MSN, NP-C
Provider Business Mailing Address
First Line : 302 POINT NORTH PL
Second Line :
City : DALTON
State : GA
Zip : 30720-2644
Country : US
Telephone Number : 706-272-4127
Fax Number : 706-279-3969
Provider Business Practice Location Address
First Line : 302 POINT NORTH PL
Second Line :
City : DALTON
State : GA
Zip : 30720-2644
Country : US
Telephone Number : 706-272-4127
Fax Number : 706-279-3969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2012
Last Update Date : 01/25/2024

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