Individual
MARY K COLLITON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 402-1638
(843) 724-2455
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1141
SC
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
1141
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0469
—
SC
Enumeration date
08/29/2006
Last updated
11/24/2020
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