Individual
KIMBERLY ELLIOTT SADRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1005 GROVE RD, GREENVILLE, SC 29605-4630
(864) 455-6900
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
103182
SC
363L00000X
Nurse Practitioner
Primary
21426
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4820
—
SC
01
—
SCB7745019
MEDICARE PIN
SC
Enumeration date
10/25/2017
Last updated
05/14/2021
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