Provider Demographics
NPI:1316544125
Name:SELLARS, MARY KATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:SELLARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-3252
Mailing Address - Country:US
Mailing Address - Phone:864-206-2520
Mailing Address - Fax:
Practice Address - Street 1:301 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-3252
Practice Address - Country:US
Practice Address - Phone:864-206-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC250014163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty