Individual
KELLY A REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
136 GOULDING AVE, BUFFALO, NY 14208-1606
(716) 903-8233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18046
SC
363LF0000X
Family Nurse Practitioner
F334655-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02735160
—
NY
Enumeration date
02/08/2006
Last updated
11/12/2021
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