Individual
MRS. KELLY LEE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
105 HILLPINE RD, APT E-1, COLUMBIA, SC 29212-2429
(803) 740-5197
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R 200774
SC
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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