KELLY COSTELLO BLACKMON

VALDOSTA, GA
NPI1992110688
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: GA  RN124057)
Enumeration Date2014-06-22
Last Update Date2015-04-07
Business Address
-- KELLY COSTELLO BLACKMON APRN
2409 N. PATTERSON STREET SUITE 230
VALDOSTA, GA 31602-2512
Phone number: 229-259-4369
Mailing Address
-- KELLY COSTELLO BLACKMON APRN
PO BOX 0070
VALDOSTA, GA 31603-0070
Phone number: 229-259-4369
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