Individual
KAYLA JO NIX MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2113 MAIN HWY, BAMBERG, SC 29003-2705
(803) 245-5168
(803) 245-6275
Mailing address
PO BOX 120, BAMBERG, SC 29003-0120
(803) 245-5168
(803) 245-6275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26729
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101027013
DRIVERS LICENSE
SC
Enumeration date
10/26/2022
Last updated
10/26/2022
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