Individual
MRS. KATHLEEN A BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9699 OCEAN HWY, WACCMAAW MEDICAL CENTER, PAWLEYS ISLAND, SC 29585-7425
(843) 237-4296
(843) 237-0495
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 652-8226
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F1372
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1370
—
SC
Enumeration date
12/05/2005
Last updated
03/05/2021
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