Individual
PROF. KIM ANNE PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, APRN
Contact information
Practice address
877 W FARIS RD STE D, GREENVILLE, SC 29605-4296
(864) 455-9031
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17491
SC
363LF0000X
Family Nurse Practitioner
Primary
17491
SC
363LF0000X
Family Nurse Practitioner
NP07598
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7006002
—
NC
05
—
NP1908
—
SC
01
—
P01001850
RAILROAD MEDICARE
SC
01
—
SC72645019
MEDICARE PIN
SC
Enumeration date
11/22/2006
Last updated
03/29/2021
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