Individual
KATHLEEN BAILEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
109 W MAIN ST, MONCKS CORNER, SC 29461-2673
(843) 719-4600
Mailing address
1975 HOLLINGS ROAD, CHARLESTON, SC 29412
(256) 302-3144
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
243333
SC
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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