MEDICARE: KRYSTEN TARBELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	550357	NC

General Provider Information

NPI Number	:	1518339522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTEN TARBELL

Provider Business Mailing Address
First Line	:	1021 GLENARDEN DR APT B
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-3585
Country	:	US
Telephone Number	:	803-389-5040
Fax Number	:	704-357-3405

Provider Business Practice Location Address
First Line	:	1021 GLENARDEN DR APT B
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-3585
Country	:	US
Telephone Number	:	803-389-5040
Fax Number	:	704-357-3405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2015
Last Update Date	:	10/29/2015

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Directions to “ KRYSTEN TARBELL ” Practice Location

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