Kelley, Kathleen M

Kelley, Kathleen M is an individual health care provider with primary practice located at 1952 Long Grove Dr Suite 202, Mt Pleasant SC 29464. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kelley, Kathleen M can be contacted via phone (843) 971-2992.

Contact Information

Primary practice address
1952 Long Grove Dr Suite 202 Mt Pleasant SC 29464
Phone: (843) 971-2992
Fax: (843) 971-2998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1877 South Carolina

Profile Details

NPI number 1649388513
LBN Legal business name Kelley, Kathleen M
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Aug 19th, 2013 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1649388513 NPPES
South Carolina MEDICAID NP0692

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