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1578988432
KELLY CANADA BRANSTETTER
COLUMBIA, SC
NPI
1578988432
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Former Name
KELLY ELIZABETH CANADA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: SC 18707)
Enumeration Date
2014-02-28
Last Update Date
2021-04-28
Business Address
KELLY CANADA BRANSTETTER CPNP
14 RICHLAND MEDICAL PARK DR STE 310
COLUMBIA, SC 29203-6883
Phone number: 803-434-8450
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Mailing Address
KELLY CANADA BRANSTETTER CPNP
PO BOX 743904
ATLANTA, GA 30374-3904
Phone number: 803-296-7320
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