Individual
KELVIN BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 GREENE ST, COLUMBIA, SC 29208-4001
(803) 413-6483
Mailing address
1601 GREENE ST, COLUMBIA, SC 29208-4001
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
210674
SC
363LF0000X
Family Nurse Practitioner
Primary
30042
SC
Other
Enumeration date
11/23/2020
Last updated
07/17/2025
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