Individual
MISS KELSEY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-2000
Mailing address
82 FOREST TRAIL CT, COLUMBIA, SC 29212-2446
(803) 955-6147
(803) 955-6147
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
260265
SC
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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