Individual
PROF. MARY B KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5046 HIGHWAY 17 BYP S, SUITE 202 AND SUITE 203, MYRTLE BEACH, SC 29588-4503
(843) 294-1941
(843) 294-1945
Mailing address
PO BOX 4746, PAWLEYS ISLAND, SC 29585-8746
(843) 294-1941
(843) 294-1945
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SC APN1721
SC
363LA2200X
Adult Health Nurse Practitioner
Primary
SC APN1721
SC
Other
Enumeration date
05/09/2007
Last updated
03/26/2014
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