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Individual

HALEY NOTTINGHAM KEITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9 HAWTHORNE PARK CT, GREENVILLE, SC 29615-3194
(864) 603-5600
(864) 603-5601
Mailing address
9 HAWTHORNE PARK CT, GREENVILLE, SC 29615-3194
(864) 603-5600
(864) 603-5601

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2639
SC
363A00000X
Physician Assistant
Primary
2639
SC

Other

Enumeration date
02/17/2017
Last updated
12/10/2020
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