Provider Demographics
NPI:1952951386
Name:BEHELER, KRISTEN CAIN
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:CAIN
Last Name:BEHELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:KIMBERLEY
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-4530
Mailing Address - Fax:864-512-4540
Practice Address - Street 1:100 HEALTHY WAY STE 1120
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-7915
Practice Address - Country:US
Practice Address - Phone:864-512-4530
Practice Address - Fax:864-512-4540
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13065363A00000X
363A00000X
SCPA3665363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant