Provider Demographics
NPI:1538661269
Name:KIGHT, PAIGE O'BRYAN (MSN, APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:O'BRYAN
Last Name:KIGHT
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:KIGHT
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2501 S VANCE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6163
Mailing Address - Country:US
Mailing Address - Phone:843-679-4019
Mailing Address - Fax:
Practice Address - Street 1:115 BLARNEY DR STE 109
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6291
Practice Address - Country:US
Practice Address - Phone:803-462-9200
Practice Address - Fax:803-699-1474
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21704363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health