Individual
KELSIE BRIANNA BLAKENEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
453 WINDRUSH DR, ELGIN, SC 29045-7902
(843) 517-2809
Mailing address
453 WINDRUSH DR, ELGIN, SC 29045-7902
(843) 517-2809
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
236018
SC
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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