Individual
KELLY GARDNER GLYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1005 GROVE RD, GREENVILLE, SC 29605-4630
(864) 455-6900
(864) 255-5619
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8615
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1275
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0974PA
—
SC
Enumeration date
11/05/2007
Last updated
10/22/2025
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