Individual
MS. COLLEEN MARCIA KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP APRN BC
Contact information
Practice address
1620 BROUGHTON ST, ORANGEBURG, SC 29115-4867
(803) 531-6030
(803) 531-6056
Mailing address
1620 BROUGHTON STREET, P.O. BOX 2549, ORANGEBURG, SC 29116
(803) 531-6030
(803) 531-6056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
616
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F75463
—
SC
Enumeration date
07/15/2006
Last updated
01/03/2013
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