Provider Demographics
NPI:1902224769
Name:PRICE, KATHY W (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:W
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 COLIES TRL
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-7610
Mailing Address - Country:US
Mailing Address - Phone:843-845-0911
Mailing Address - Fax:
Practice Address - Street 1:410 COLIES TRL
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-7610
Practice Address - Country:US
Practice Address - Phone:843-845-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-30
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC55464163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health