Provider Demographics
NPI:1992566939
Name:ADAMS, KELLI ALLISON (FNP)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:ALLISON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 GIBSON RD
Mailing Address - Street 2:
Mailing Address - City:LANDRUM
Mailing Address - State:SC
Mailing Address - Zip Code:29356-9473
Mailing Address - Country:US
Mailing Address - Phone:843-343-6822
Mailing Address - Fax:
Practice Address - Street 1:11 SUNSHINE LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-0237
Practice Address - Country:US
Practice Address - Phone:828-859-7659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine