Individual
KATHLEEN O PRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
122 S GOOSE CREEK BLVD STE B, GOOSE CREEK, SC 29445-3136
(843) 553-2211
(843) 553-2210
Mailing address
122 S GOOSE CREEK BLVD STE B, GOOSE CREEK, SC 29445-3136
(843) 553-2211
(843) 553-2210
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3562
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP4978
MEDICAID GROUP
SC
05
—
NP1390
—
SC
Enumeration date
06/04/2008
Last updated
01/24/2020
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