Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | RN147515CNM | GA |
N | 207V00000X | Obstetrician & Gynecologist | RN147515 | GA |
NPI | 1083766315 |
---|---|
Provider Name | Kelley Wages Starnes |
First Address | Atlanta, GA 30305-1717 |
Second Address | Duluth, GA 30096-4506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 07/01/2022 |