Healthcare Provider Details

I. General information

NPI: 1427740505
Provider Name (Legal Business Name): KAYLAN MARTIN ESTENES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE KAYLAN MARTIN

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 HOPE POND WAY UNIT 104
BLUFFTON SC
29910-3439
US

IV. Provider business mailing address

375 HOPE POND WAY UNIT 104
BLUFFTON SC
29910-3439
US

V. Phone/Fax

Practice location:
  • Phone: 843-707-0006
  • Fax:
Mailing address:
  • Phone: 843-707-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.30457
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP248019
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: