Individual
MRS. KENNEDY AUGUST STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
96 JONATHAN LUCAS ST STE 816, CHARLESTON, SC 29425-8900
(843) 792-3167
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11581658-4405
UT
363LA2100X
Acute Care Nurse Practitioner
Primary
28124
SC
Other
Enumeration date
10/30/2023
Last updated
01/16/2025
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