Provider Demographics
NPI:1134946973
Name:TOSTON, KHANH LY
Entity type:Individual
Prefix:MRS
First Name:KHANH LY
Middle Name:
Last Name:TOSTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 EPTING AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4041
Mailing Address - Country:US
Mailing Address - Phone:864-227-6818
Mailing Address - Fax:
Practice Address - Street 1:421 EPTING AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4041
Practice Address - Country:US
Practice Address - Phone:864-227-6818
Practice Address - Fax:864-227-0850
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29941363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily