Individual
KAITLYN MICHELLE HOLBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
890 W FARIS RD STE 310, GREENVILLE, SC 29605-4281
(864) 455-8300
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3604
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4263PA
—
SC
Enumeration date
06/15/2020
Last updated
03/02/2022
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