Individual
KEYRA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
199 HAMILTON LN, YEMASSEE, SC 29945-4737
(843) 562-6324
Mailing address
199 HAMILTON LN, YEMASSEE, SC 29945-4737
(843) 562-6324
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
49769
SC
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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