Individual
KAYLEIGH BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
369 HALTON RD, GREENVILLE, SC 29607-3405
(864) 479-8774
Mailing address
369 HALTON RD, GREENVILLE, SC 29607-3405
(864) 479-8774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6369
SC
363A00000X
Physician Assistant
PA16818
TX
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/30/2021
Last updated
05/21/2026
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