Provider Demographics
NPI:1497322895
Name:KING, KAYCE LEE (CRNA)
Entity Type:Individual
Prefix:
First Name:KAYCE
Middle Name:LEE
Last Name:KING
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAYCE
Other - Middle Name:LEE
Other - Last Name:CONWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:814 S WOODROW ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4442
Mailing Address - Country:US
Mailing Address - Phone:980-322-8653
Mailing Address - Fax:
Practice Address - Street 1:814 S WOODROW ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-4442
Practice Address - Country:US
Practice Address - Phone:980-322-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-06
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC258348163W00000X
NC147266367500000X
NC7220367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse