Individual
PROF. KISHA BEACH PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CALLEN BLVD, SUMMERVILLE, SC 29486-2807
(843) 343-2432
Mailing address
1427 PINETHICKET DR, SUMMERVILLE, SC 29486-8661
(843) 343-2432
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
81496
SC
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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