Individual
MRS. GWENDELL MCDANIEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3424 CLEMSON BLVD, ANDERSON, SC 29621
(864) 261-3022
Mailing address
200 BROWNING RD, CENTRAL, SC 29630-9440
(864) 650-7475
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
86088
SC
363LF0000X
Family Nurse Practitioner
Primary
22120
SC
Other
Enumeration date
04/11/2018
Last updated
08/08/2018
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