Individual
MS. HOLLY GWALTNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1468
(803) 531-6900
Mailing address
16 CARLISLE ST, BAMBERG, SC 29003-1360
(803) 707-1219
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1724
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5401724
LICENSE
SC
Enumeration date
07/08/2006
Last updated
03/06/2024
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