Individual
JENNIFER AMY KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 MEDICAL PARK, PALMETTO HEALTH RICHLAND, COLUMBIA, SC 29203
(803) 296-2548
(803) 296-2548
Mailing address
293 GREYSTONE BLVD, FIRST FLOOR, COLUMBIA, SC 29210-8004
(803) 296-2548
(803) 296-2548
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2631
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1434
—
SC
Enumeration date
04/27/2006
Last updated
05/19/2014
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