Individual
ELIZABETH RYAN KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1105 N LAFAYETTE DR STE A, SUMTER, SC 29150-2984
(803) 934-8833
Mailing address
2030 HATTERAS WAY, SUMTER, SC 29153-1966
(717) 880-7262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21789
SC
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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