Jackson, Kellontreia Laporche

Jackson, Kellontreia Laporche is an individual health care provider with primary practice located at 2732 Candler Rd , Decatur GA 30034-1410. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Jackson, Kellontreia Laporche can be contacted via phone (470) 444-3133.

Contact Information

Primary practice address
2732 Candler Rd Decatur GA 30034-1410
Phone: (470) 444-3133
Fax: (470) 276-4051
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN259383 Georgia

Profile Details

NPI number 1619685534
LBN Legal business name Jackson, Kellontreia Laporche
Credentials A-GNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2022
Last updated Aug 3rd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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