Individual
KIM O MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
190 PARKRIDGE DRIVE, SUITE 250, COLUMBIA, SC 29212-1747
(803) 407-3857
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN 856
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1354
—
SC
Enumeration date
03/09/2007
Last updated
09/09/2011
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