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NPI Code Detail

MEDICARE: STEPHANIE ALBERS KELLY R.N.

MEDICARE: STEPHANIE ALBERS KELLY R.N.
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
1374700000XTechnician81452SC

General Provider Information

NPI Number : 1154766186
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ALBERS KELLY R.N.
Provider Business Mailing Address
First Line : 2685 LEEDS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6861
Country : US
Telephone Number : 843-529-3150
Fax Number : 843-720-3142
Provider Business Practice Location Address
First Line : 2685 LEEDS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6861
Country : US
Telephone Number : 843-529-3150
Fax Number : 843-720-3142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2013
Last Update Date : 05/03/2013

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