Individual
MRS. KELLY MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1119 N IRBY ST, FLORENCE, SC 29501-2621
(843) 664-8162
(843) 664-8178
Mailing address
1119 N IRBY ST, FLORENCE, SC 29501-2621
(843) 664-8162
(843) 664-8178
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
78085
SC
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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