Individual
KIIRA KATHRYN MENDENHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
21776
SC
Other
Enumeration date
06/11/2018
Last updated
07/17/2018
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