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Individual

KIM WALDENMAIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
101 E WOOD ST STE 330, SPARTANBURG, SC 29303-3040
(864) 560-6522
(888) 972-8644
Mailing address
PO BOX 678207, DALLAS, TX 75267-8207
(800) 841-4236
(706) 653-1162

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN2669
SC
363LF0000X
Family Nurse Practitioner
APN2669
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7003918
NC
05
NP0915
SC
Enumeration date
11/15/2005
Last updated
03/27/2019
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