Haddock, Kristin Braveboy

Haddock, Kristin Braveboy is an individual health care provider with primary practice located at 420 Society Hill Dr Ste 100 , Aiken SC 29803-1731. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Haddock, Kristin Braveboy can be contacted via phone (803) 648-7774.

Contact Information

Primary practice address
420 Society Hill Dr Ste 100 Aiken SC 29803-1731
Phone: (803) 648-7774
Fax: (803) 648-7490
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2601 South Carolina

Profile Details

NPI number 1053384073
LBN Legal business name Haddock, Kristin Braveboy
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Mar 7th, 2019 - 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 1053384073 NPPES
South Carolina MEDICAID NP0888

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