Individual
KIMBERLY PELICANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 BLAINE CT, GREENVILLE, SC 29607-6259
(404) 731-0232
Mailing address
311 BLAINE CT, GREENVILLE, SC 29607-6259
(404) 731-0232
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
257467
SC
Other
Enumeration date
06/05/2026
Last updated
06/05/2026
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