Individual
KELLY EADDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
137 N ACLINE ST, LAKE CITY, SC 29560-2107
(843) 394-8822
(843) 394-8856
Mailing address
137 N ACLINE ST, LAKE CITY, SC 29560-2107
(843) 394-8822
(843) 394-8856
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
67855
SC
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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