Individual
MERRY ANN IGNACIO MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4605 MONTICELLO RD, COLUMBIA, SC 29203-4156
(803) 252-7001
Mailing address
1228 HARDEN ST, COLUMBIA, SC 29204-1800
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4068
SC
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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