Individual
MRS. KATHLEEN M KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1952 LONG GROVE DR, SUITE 202, MT PLEASANT, SC 29464
(843) 971-2992
(843) 971-2998
Mailing address
2051 CHARLIE HALL BLVD, CHARLESTON, SC 29414
(843) 573-2535
(843) 573-2534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1877
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0692
—
SC
Enumeration date
08/29/2006
Last updated
08/19/2013
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