Individual
KEVIN BRENNEN CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 313-3234
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3321
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26361
SC
Other
Enumeration date
08/03/2022
Last updated
11/21/2022
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