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Individual

MRS. KELLY WILLIAMS RYDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1740 HIGHWAY 160 W, FORT MILL, SC 29708-8025
(866) 389-2727
Mailing address
1912 WEDGEDALE DR, CHARLOTTE, NC 28210-4544
(703) 400-2551

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024191517
VA
363LF0000X
Family Nurse Practitioner
Primary
27403
SC
363LF0000X
Family Nurse Practitioner
5016854
NC
363LF0000X
Family Nurse Practitioner
95021706
CA

Other

Enumeration date
09/06/2022
Last updated
10/15/2025
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