● Active Type 1 · Individual

DR. Coretta D. Keith, DNP, FNP-BC

Nurse Practitioner·Tifton, GA· NPI 1306884374 · Enumerated 2006 · 19 years on NPI

Keith is 1 of 29 nurse practitioner providers in Tifton and 1 of 3206 in Georgia.

NPI age

19 years

Enumerated 2006-06-03

Primary specialty

Nurse Practitioner

Plus 1 subspecialty

Licensed in

GA, AZ

2 states

Status

Active

No deactivations on record

Last NPPES update

2021-05-04

Source: monthly bulk 2026-05

Sole proprietor

Yes

Solo practice on file

How this provider compares

Across 3206 active nurse practitioner providers in Georgia.

NPI age

19 years

↑ 11 yr above median (8 yr)

State licenses

2 states

Top 91% — 8% of peers are multi-state

Subspecialties

In the 30% of peers with subspecialties

NPI lifetime · 2006 → 2026

2006-06Enumerated in NPPES

2006 2026

Where they practice

Practice location

901 18th St E

Tifton, GA 317943648

📞 2293827120

Mailing address

116 Beowulf Ln

Leesburg, GA 317635831

📞 4047106646

Specialties

Physician Assistants & Advanced Practice Nursing Providers › Nurse Practitioner

Nurse Practitioner Primary

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum...

GA license #RN124581 taxonomy 363L00000X
Nurse Practitioner

Definition to come...

AZ license #AP4450 taxonomy 363LF0000X

Identifiers

Type	Value	Notes
01 (GA)	P00266428	RAILROAD MEDICARE
05 (GA)	000927198E

Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.

Practice context

Part of a multi-provider practice. 169 other active providers share this practice address in NPPES.

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How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.