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Individual

JALISSA C KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
102 CATHCART CIR, WINNSBORO, SC 29180-1028
(839) 207-0558
(839) 207-0558
Mailing address
102 CATHCART CIR, WINNSBORO, SC 29180-1028
(839) 207-0558
(839) 207-0558

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
31456
SC

Other

Enumeration date
01/27/2026
Last updated
01/27/2026
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