Healthcare Provider Details

I. General information

NPI: 1619868536
Provider Name (Legal Business Name): KIRSTYN KIRKLAND GARRON PMHNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CENTER POINT RD STE 2350
COLUMBIA SC
29210-5826
US

IV. Provider business mailing address

2000 CENTER POINT RD STE 2350
COLUMBIA SC
29210-5826
US

V. Phone/Fax

Practice location:
  • Phone: 803-669-8887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number228609
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number30877
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: