Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLIE TEDISCO
Active Sole ProprietorKELLIE TEDISCO is a Child & Adolescent Psychiatric Nurse healthcare provider located in LUTHERSVILLE, Georgia. NPI 1780233452 is currently active in the NPPES registry. Verify at CMS.
Child & Adolescent Psychiatric Nurse · LUTHERSVILLE, GA
Registration Details
- NPI Number
- 1780233452
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 5, 2019 (6.9341141903051 yrs)
- Last Updated
- Sep 5, 2019
- License
-
RN231182 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
129 KELLY FARM DRLUTHERSVILLE, GA, 302511607Browse GA providers · Browse ZIP 30251
- Phone
- 7705103520
- Primary Specialty
-
Child & Adolescent Psychiatric Nurse
163WP0808X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.