Individual
JILLIAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4301 DICK POND RD, MYRTLE BEACH, SC 29588-6807
(843) 652-8100
(843) 652-8122
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 527-7000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29126
SC
Other
Enumeration date
09/13/2018
Last updated
11/21/2025
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