Individual
MRS. AMANDA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-8001
Mailing address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
89124
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
3802
SC
Other
Enumeration date
11/18/2008
Last updated
02/26/2009
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