Provider Demographics
NPI:1023359452
Name:ALLEN, KATHRYN KAISER (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:KAISER
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BONEY RD
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-9409
Mailing Address - Country:US
Mailing Address - Phone:803-691-6880
Mailing Address - Fax:803-691-6883
Practice Address - Street 1:125 BONEY RD
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-9409
Practice Address - Country:US
Practice Address - Phone:803-691-6880
Practice Address - Fax:803-691-6883
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54185163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool