KELLY DIANE MCCARLEY


Address: 1908 Tarver Dr, Blakely, GA 39823-1540
Phone: 2293080460

KELLY DIANE MCCARLEY (NPI# 1649753773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649753773
Entity Type Individual
Full Name KELLY DIANE MCCARLEY
Practice Address 1908 Tarver Dr
Blakely
GA 39823-1540
Practice Telephone 2293080460
Mailing Telephone 2293080460
Enumeration Date 2018-09-14
Last Update Date 2018-09-14
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
RN219753 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1908 TARVER DR
City BLAKELY
State GA
Zip Code 39823-1540

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1679922546 Donna Lashawn Mells-mccoy Social Worker 89 Balcom Ave, Blakely, GA 39823 2016-06-10
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1780607754 Primary Care of Southwest Georgia, Inc. Nurse Practitioner 360 College Street, Blakely, GA 39823 2006-07-25
1588014807 Dave Stewart Family Medicine 360 College St, Blakely, GA 39823 2016-06-17
1497805063 Miller County Hospital and Miller Nursing Home Clinic/Center 11045 Columbia St, Blakely, GA 39823 2007-01-12
1437345006 Ralph Boyd Phillips Jr. Chiropractor 12221 Columbia Road, Blakely, GA 39823-0231 2007-09-18
1437585635 Marrian Alexander Nurse Practitioner 1924 Tarver Dr, Blakely, GA 39823-1540 2013-09-19
1508403049 Rachel Lewis Specialist/Technologist 326 Tom Sawyer Dr, Blakely, GA 39823-1559 2019-12-03
1508177825 Charles Paschal Brooks Jr. Dentist 13762 Magnolia St, Blakely, GA 39823-1875 2010-07-01
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City BLAKELY
Zip Code 39823

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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