Individual provider · Type 1 NPI

Kelly Bailey Kruse, PAC

Surgical Physician Assistant · Charleston, SC

NPI number 1942235247 Active

Practice location

2093 Henry Tecklenburg Dr Ste 200
Charleston, SC 29414-5742

Call (843) 958-2500 Map

Mailing address

PO Box 751649
Charlotte, NC 28275-1649

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X496 (SC)

Surgical Physician Assistant: Definition to come...

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About NPI 1942235247

Kelly Bailey Kruse, PAC's National Provider Identifier is 1942235247, issued on Jul 12, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Charleston, SC. The record was last updated on Apr 25, 2025.