GRACE L KELSON LPN
NPI 1114456514
Licensed Practical Nurse in Riverdale, GA

Active since June 08, 2017
9142 CLUBHOUSE DR, RIVERDALE, GA 30274(404) 747-2575 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Jun 8, 2017 (2 updates tracked since 2017).

  • Individual
  • Female
  • Licensed Practical Nurse

About GRACE KELSON

This page provides the complete NPI Profile along with additional information for Grace Kelson, a provider established in Riverdale, Georgia with a medical specialization in Licensed Practical Nurse. The healthcare provider is registered in the NPI registry with number 1114456514 assigned on June 2017. The practitioner's primary taxonomy code is 164W00000X with license number 87808 (GA). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1114456514 Verify this NPI
Provider Name
GRACE L KELSON LPN
Gender
Female
Entity Type
Individual
Location Address
9142 CLUBHOUSE DR RIVERDALE, GA 30274
Location Phone
(404) 747-2575
Mailing Address
9142 CLUBHOUSE DR RIVERDALE, GA 30274
Mailing Phone
(404) 747-2575
Is Sole Proprietor?
Yes
Enumeration Date
06-08-2017
Last Update Date
07-21-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Licensed Practical Nurse

Taxonomy Code
164W00000X
Type
Nursing Service Providers
License No.
87808
License State
GA
Taxonomy Description
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114456514, enumerated as an "individual" on June 08, 2017.

The provider is located at 9142 CLUBHOUSE DR RIVERDALE, GA 30274 and the phone number is (404) 747-2575.

Licensed Practical Nurse with taxonomy code 164W00000X.