Individual
KELLI SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 NASSAU ST, CHARLESTON, SC 29403-6227
(864) 918-0537
Mailing address
22 NASSAU ST, CHARLESTON, SC 29403-6227
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20376
SC
Other
Enumeration date
09/03/2016
Last updated
09/03/2016
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