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Individual

MARY W KAYSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
4605 MONTICELLO RD, COLUMBIA, SC 29203-4156
(803) 252-7001
(803) 252-5219
Mailing address
4605 MONTICELLO RD, COLUMBIA, SC 29203-4156
(803) 252-7001
(803) 252-5219

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN1242
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APN1242
STATE LICENCE NUMBER
SC
05
NP1795
SC
Enumeration date
08/01/2005
Last updated
06/02/2011
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