Healthcare Provider Details

I. General information

NPI: 1538091483
Provider Name (Legal Business Name): KAITLYN FLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 JONATHAN LUCAS ST
CHARLESTON SC
29425-8900
US

IV. Provider business mailing address

1 POSTON RD STE 110
CHARLESTON SC
29407-3457
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-8515
  • Fax:
Mailing address:
  • Phone: 843-792-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number271924
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: