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Individual

MRS. KELLY COLE WOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP

Contact information

Practice address
2995 REIDVILLE RD STE 210, SPARTANBURG, SC 29301-5631
(864) 587-3000
(864) 587-3019
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20804
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP4574
SC
01
SCA7546067
MEDICARE PIN
SC
01
SCA7546084
MEDICARE PIN
SC
01
SCA754J577
MEDICARE PIN
SC
Enumeration date
04/11/2017
Last updated
01/10/2020
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