Provider Demographics
NPI:1811580186
Name:FRIERSON, KRISTIN (LPN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FRIERSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 S CASHUA DR APT 10
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5305
Mailing Address - Country:US
Mailing Address - Phone:843-496-5010
Mailing Address - Fax:
Practice Address - Street 1:1341 N CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6939
Practice Address - Country:US
Practice Address - Phone:843-673-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP468367164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse