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1164804019
MELISSA KELLUM PARENT
CHARLESTON, SC
NPI
1164804019
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Former Name
MELISSA KELLUM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: SC 19559)
Enumeration Date
2015-06-26
Last Update Date
2020-10-28
Business Address
MELISSA KELLUM PARENT AGACNP
169 ASHLEY AVE
CHARLESTON, SC 29425-8905
Phone number: 843-792-2123
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Mailing Address
MELISSA KELLUM PARENT AGACNP
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number:
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