Individual
KATHERINE KONCHALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 PATEWOOD DR STE A200, GREENVILLE, SC 29615-3580
(864) 454-5115
(864) 454-5111
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
19064
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2958
—
SC
Enumeration date
09/17/2014
Last updated
06/14/2021
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