Type | Legal entity | [sources] | |||
---|---|---|---|---|---|
Name | Fithian, Kelly Beth | [sources] | |||
Other name | Kelly Archer | [sources] | |||
Legal form | not available | [sources] | |||
Country | United States of America | [sources] | |||
NPI | 1568665057 | [sources] | |||
Sector | Nursing Profession - Nurse/Nurses Aide | [sources] | |||
Status | not available | [sources] | |||
Address | Loris, SC 29569 | [sources] | |||
Last change | Last processed | First seen |
Medical providers excluded from South Carolina's Medicaid program.
United States of America · SCDHHS
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