Caldwell, Keionda Crumblin

Caldwell, Keionda Crumblin is an individual health care provider with primary practice located at 4605 Monticello Rd Ste 2 , Columbia SC 29203-4156. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Caldwell, Keionda Crumblin can be contacted via phone (803) 753-5590.

Contact Information

Primary practice address
4605 Monticello Rd Ste 2 Columbia SC 29203-4156
Phone: (803) 753-5590
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 20857 South Carolina

Profile Details

NPI number 1487185484
LBN Legal business name Caldwell, Keionda Crumblin
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2017
Last updated Feb 27th, 2018 - about 7 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 1487185484 NPPES
South Carolina MEDICAID NP4722

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