Individual
KARA JANE SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 LAURENS RD, GREENVILLE, SC 29607-3224
(864) 288-8280
Mailing address
111 N ELM ST, PENDLETON, SC 29670-1729
(843) 267-9998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23052
SC
363LF0000X
Family Nurse Practitioner
23032
SC
363LF0000X
Family Nurse Practitioner
Primary
23052
SC
Other
Enumeration date
07/15/2019
Last updated
09/11/2020
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