Individual
KELLY SUZANNE HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 CREOLA RD, CHARLESTON, SC 29420-8703
(843) 767-5905
(843) 767-5927
Mailing address
3300 CREOLA RD, CHARLESTON, SC 29420-8703
(843) 767-5905
(843) 767-5927
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
94454
SC
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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