Provider Demographics
NPI:1568402337
Name:BLESSITT, KRISTI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:LYNN
Last Name:BLESSITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 280
Mailing Address - Street 2:29 PLANTATION PARK DRIVE, SUITE 204
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910
Mailing Address - Country:US
Mailing Address - Phone:843-715-0570
Mailing Address - Fax:843-715-0570
Practice Address - Street 1:29 PLANTATION PARK DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910
Practice Address - Country:US
Practice Address - Phone:843-715-0570
Practice Address - Fax:843-715-0570
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18138174400000X
SCTL30791207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC09333019Medicaid
MS09333019Medicaid
104833Medicare PIN
16000624Medicare UPIN
MSI04833Medicare UPIN