Provider Demographics
NPI:1760370621
Name:KINARD, BRANNA KURSTAN
Entity type:Individual
Prefix:
First Name:BRANNA
Middle Name:KURSTAN
Last Name:KINARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2972 MCCORDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:SC
Mailing Address - Zip Code:29030-8581
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:332 STONEWALL JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-7291
Practice Address - Country:US
Practice Address - Phone:803-997-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC60628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist