Individual
CAROLINE KENNERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2728 SUNSET BLVD STE 300, WEST COLUMBIA, SC 29169-4815
(803) 744-4900
(803) 744-4938
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 744-4900
(803) 744-4938
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
29388
SC
Other
Enumeration date
02/14/2024
Last updated
02/28/2025
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