Provider Demographics
NPI:1609081835
Name:MCKELLAR, BARBARA JOHNSON (ADULT NURSE PRACTITI)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JOHNSON
Last Name:MCKELLAR
Suffix:
Gender:F
Credentials:ADULT NURSE PRACTITI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HAYWAIN DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-9713
Mailing Address - Country:US
Mailing Address - Phone:803-345-1673
Mailing Address - Fax:
Practice Address - Street 1:HEALTHWORKS
Practice Address - Street 2:TAYLOR AT MARION STREET
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29220-0001
Practice Address - Country:US
Practice Address - Phone:803-296-3500
Practice Address - Fax:803-296-3965
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN645363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health