Individual
MS. KELLY JANE THUMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
Mailing address
920 DOUG WHITE DR STE 510, MYRTLE BEACH, SC 29572-4183
(843) 497-7772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
25776
SC
Other
Enumeration date
02/01/2022
Last updated
02/18/2025
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