Individual
KELLY M CANTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 935-8538
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2203
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4081
SC
367500000X
Certified Registered Nurse Anesthetist
NA95000765
CA
390200000X
Student in an Organized Health Care Education/Training Program
76993
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN2026
—
SC
Enumeration date
09/29/2009
Last updated
09/15/2025
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