Provider Demographics
NPI:1558995357
Name:WERTS, KRISTIN HODGES (RN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:HODGES
Last Name:WERTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WOODLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-3955
Mailing Address - Country:US
Mailing Address - Phone:864-984-3986
Mailing Address - Fax:
Practice Address - Street 1:601 LUCAS AVE
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2149
Practice Address - Country:US
Practice Address - Phone:864-984-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102143163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics