Individual
KRISTIN BRAVEBOY HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
420 SOCIETY HILL DR STE 100, AIKEN, SC 29803-1731
(803) 648-7774
(803) 648-7490
Mailing address
367 S. GULPH RD, ATT: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(803) 648-7774
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2601
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0888
—
SC
Enumeration date
02/09/2006
Last updated
03/07/2019
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