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NPI Code Detail

MEDICARE: ELIZABETH ERIN KELLY FNP

MEDICARE:   ELIZABETH ERIN KELLY  FNP
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
1363LF0000XFamily Nurse Practitioner2023032360SC
2363LF0000XFamily Nurse Practitioner28045SC

General Provider Information

NPI Number : 1861276792
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ERIN KELLY FNP
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number :
Provider Business Practice Location Address
First Line : 1351 CRESTVIEW RD
Second Line :
City : EASLEY
State : SC
Zip : 29642-2408
Country : US
Telephone Number : 864-855-5006
Fax Number : 864-850-1992
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 11/06/2023

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Directions to “ ELIZABETH ERIN KELLY FNP” Practice Location

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