Individual
KELLI FISHBURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
447 SPRUCE ST, WALTERBORO, SC 29488-2766
(843) 549-6331
Mailing address
447 SPRUCE ST, WALTERBORO, SC 29488-2766
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06240189
SC
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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