Individual
MS. KATHRYN S MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8301 FARROW RD, COLUMBIA, SC 29203-3245
(803) 255-3417
(803) 255-3451
Mailing address
15 MEDICAL PARK RD, SUITE 300, COLUMBIA, SC 29203
(803) 255-3417
(803) 255-3451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2154
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0964
—
SC
Enumeration date
07/03/2006
Last updated
07/08/2007
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