Individual
MRS. KEIONDA CRUMBLIN CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4605 MONTICELLO RD STE 2, COLUMBIA, SC 29203-4156
(803) 753-5590
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20857
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4722
—
SC
Enumeration date
03/22/2017
Last updated
02/27/2018
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