Provider Demographics
NPI:1720613938
Name:MEDLIN, KATHRYN ASHTON (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ASHTON
Last Name:MEDLIN
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 1:3180 THOMASINA MCPHERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8283
Mailing Address - Country:US
Mailing Address - Phone:843-745-2184
Mailing Address - Fax:843-745-2182
Practice Address - Street 1:3180 THOMASINA MCPHERSON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8283
Practice Address - Country:US
Practice Address - Phone:843-745-2184
Practice Address - Fax:843-725-2182
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-08
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC210156163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool