Beverly, Kaitlyn B

Beverly, Kaitlyn B is an individual health care provider with primary practice located at 620 Singleton Ridge Road , Conway SC 29526-9154. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Beverly, Kaitlyn B can be contacted via phone (843) 347-7300.

Contact Information

Primary practice address
620 Singleton Ridge Road Conway SC 29526-9154
Phone: (843) 347-7300
Fax: (843) 347-8459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X

Profile Details

NPI number 1255974655
LBN Legal business name Beverly, Kaitlyn B
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2019
Last updated Oct 18th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255974655 NPPES
South Carolina MEDICAID 4261PA

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