Individual
KELLY ARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4095
Mailing address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4095
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
20183
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6050
—
SC
Enumeration date
05/17/2016
Last updated
01/07/2026
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