Healthcare Provider Details

I. General information

NPI: 1780220921
Provider Name (Legal Business Name): KRISTEN M CAULDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SC HOUSE CALLS INC 111 DOCTORS CIRCLE
COLUMBIA SC
29203
US

IV. Provider business mailing address

SC HOUSE CALLS INC 111 DOCTORS CIRCLE
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-0909
  • Fax: 803-245-6274
Mailing address:
  • Phone: 800-491-0909
  • Fax: 803-245-6274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23422
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23422
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: