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Individual

MRS. KELLEY HODGE BOSTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
701 MEDICAL PARK DR STE 301, HARTSVILLE, SC 29550-4779
(843) 383-5978
(843) 383-5977
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21427
SC
363LF0000X
Family Nurse Practitioner
Primary
21427
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP4882
SC
Enumeration date
10/31/2017
Last updated
03/02/2022
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