| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Fithian, Kelly Beth | [sources] | |||
| Alias | Kelly Archer | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [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 · SCDHHS
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