Healthcare Provider Details

I. General information

NPI: 1093641227
Provider Name (Legal Business Name): NATHANAEL KADE KIRKPATRICK BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

4403 DENVER COVE RD
ANDERSON SC
29625-6208
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number240563
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: