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Individual

JAMIE LYNN KILCOYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
525 VERDAE BLVD STE 150, GREENVILLE, SC 29607-4021
(864) 516-1783
Mailing address
525 VERDAE BLVD STE 150, GREENVILLE, SC 29607-4021
(864) 516-1783

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17898
SC
363LF0000X
Family Nurse Practitioner
Primary
17898
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP2102
SC
01
P01110426
RAILROAD MEDICARE
SC
01
SCE6856084
MEDICARE PIN
SC
Enumeration date
08/01/2012
Last updated
03/17/2025
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