Individual
KATHLEEN A HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
USC THOMSON STUDENT HEALTH CENTER, GREENE STREET ROOM 302, COLUMBIA, SC 29208-0001
(803) 777-5373
(803) 777-6965
Mailing address
USC THOMSON STUDENT HEALTH CENTER, GREENE STREET ROOM 302, COLUMBIA, SC 29208-0001
(803) 777-5373
(803) 777-6965
Taxonomy
Speciality
Code
Description
License number
State
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R50692
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA65896580
MEDICARE PTAN
SC
05
—
NP0416
—
SC
Enumeration date
05/17/2006
Last updated
05/13/2011
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