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General NPI Number Information
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NPI Number | 1912619883
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Entity Type | Individual
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Provider Name | KAMAU CASEY GILLARD APRN
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Gender | Male
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | SC HOUSE CALLS INC 111 DOCTORS CIRCLE
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City | COLUMBIA
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State | SC
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Zip | 29203
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Country | US
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Telephone | 800-491-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 147 WALNUT ST
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City | WELLESLEY
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State | MA
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Zip | 02481
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Country | US
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Telephone | 617-759-2004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 205520
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26903
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License Number State | SC
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