Individual
KRISTEN LYNNE MACCLENAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
890 W FARIS RD, SUITE 330, GREENVILLE, SC 29605-4253
(864) 233-1112
(864) 233-1204
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25290
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252906
—
SC
01
—
571004971010
BCBS
SC
01
—
P00620613
RR MEDICARE
SC
Enumeration date
03/09/2007
Last updated
08/21/2013
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