Individual
LYN-MARIE KUBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
(843) 663-8000
(843) 663-8123
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8000
(843) 663-8123
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105268
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
SC
Enumeration date
03/02/2020
Last updated
03/02/2020
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