Individual
KADEIDRE LA'TRELL GAYMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 920-6625
Mailing address
286 LIBERTY RIDGE DR, ELGIN, SC 29045-7905
(803) 920-6625
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
249257
SC
163WC0200X
Critical Care Medicine Registered Nurse
Primary
249257
SC
163WH0200X
Home Health Registered Nurse
249257
SC
163WW0000X
Wound Care Registered Nurse
249257
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PVF908740801
BLUE CROSS BLUE SHIELD
TN
Enumeration date
08/11/2021
Last updated
08/11/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us