Healthcare Provider Details

I. General information

NPI: 1568402337
Provider Name (Legal Business Name): KRISTI LYNN BLESSITT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 PLANTATION PARK DRIVE SUITE 204
BLUFFTON SC
29910
US

IV. Provider business mailing address

P.O. BOX 280 29 PLANTATION PARK DRIVE, SUITE 204
BLUFFTON SC
29910
US

V. Phone/Fax

Practice location:
  • Phone: 843-715-0570
  • Fax: 843-715-0570
Mailing address:
  • Phone: 843-715-0570
  • Fax: 843-715-0570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number18138
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberTL30791
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: