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Organization
ANDERSON DISTRICT 4
Active
Organization
ANDERSON DISTRICT 4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTI WALTERS MARTIN R.N. (REGISTERED NURSE)
(864) 403-2400
Entity
Organization
Contact information
Practice address
2850 LEBANON RD, PENDLETON, SC 29670-9482
(864) 403-2400
(864) 716-3654
Mailing address
2850 LEBANON RD, PENDLETON, SC 29670-9482
(864) 403-2400
(864) 716-3654
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
62308
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0404
—
SC
Enumeration date
01/08/2013
Last updated
01/08/2013
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