Provider Demographics
NPI:1578012134
Name:STEELE, KANDRALYN (PNP)
Entity Type:Individual
Prefix:
First Name:KANDRALYN
Middle Name:
Last Name:STEELE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NEW RIVER PKWY
Mailing Address - Street 2:SUITE 16
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-4450
Mailing Address - Country:US
Mailing Address - Phone:843-203-5495
Mailing Address - Fax:843-782-3269
Practice Address - Street 1:300 NEW RIVER PKWY
Practice Address - Street 2:SUITE 16
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-4450
Practice Address - Country:US
Practice Address - Phone:843-203-5495
Practice Address - Fax:843-782-3269
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20485363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics