Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Tickle, PCNS-BC, PPCNP-BC

Individual provider Pediatric Nurse Practitioner · NPI 1417379538

Kelly Tickle, PCNS-BC, PPCNP-BC is a Pediatric Nurse Practitioner in Atlanta, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2014
Specialties on file
3

Practice location Address checks out

5455 Meridian Marks Rd Ste 400
Atlanta, GA 30342-4723
Phone: (404) 785-3240
Fax: (404) 785-3600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence APRN-NP228738 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN228738 (GA)
Pediatric Clinical Nurse Specialist Taxonomy 364SP0200X · Licence APRN-CNS228738 (GA)

Record details

NPI number1417379538
Entity typeIndividual (Type 1)
GenderFemale
Credentials PCNS-BC , PPCNP-BC
Sole proprietorYes
NPI enumeratedJanuary 8, 2014
Last updated in NPPESOctober 31, 2025
Certification dateOctober 31, 2025

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