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NPI Code Detail

MEDICARE: DR. HANNAH KELLAM KLOCH DNP, PMHNP-BC, FNP-C

MEDICARE:  DR. HANNAH KELLAM KLOCH  DNP, PMHNP-BC, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse240564SC
2363LF0000XFamily Nurse Practitioner24116SC
3363LP0808XPsychiatric/Mental Health Nurse Practitioner24116SC

General Provider Information

NPI Number : 1063037430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HANNAH KELLAM KLOCH DNP, PMHNP-BC, FNP-C
Provider Business Mailing Address
First Line : 1602 HIGHWAY 17 N
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29575-6015
Country : US
Telephone Number : 843-238-3332
Fax Number :
Provider Business Practice Location Address
First Line : 1500 HIGHWAY 17 N STE 101
Second Line :
City : SURFSIDE BEACH
State : SC
Zip : 29575-6079
Country : US
Telephone Number : 843-604-3012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2020
Last Update Date : 05/08/2025

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Directions to “ DR. HANNAH KELLAM KLOCH DNP, PMHNP-BC, FNP-C” Practice Location

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