Provider Demographics
NPI:1629389473
Name:KNIGHT-SCHLONDROP, LLC
Entity Type:Organization
Organization Name:KNIGHT-SCHLONDROP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KNIGHT-SCHLONDROP
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:803-979-9666
Mailing Address - Street 1:6326 SAINT ANDREWS RD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3126
Mailing Address - Country:US
Mailing Address - Phone:803-979-9666
Mailing Address - Fax:800-878-6608
Practice Address - Street 1:6326 SAINT ANDREWS RD
Practice Address - Street 2:SUITE # 201
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3126
Practice Address - Country:US
Practice Address - Phone:803-979-9666
Practice Address - Fax:800-878-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-26
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9610OtherMEDICARE PTAN