Healthcare Provider Details

I. General information

NPI: 1427474436
Provider Name (Legal Business Name): KAREN KAISER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PATEWOOD DR SUITE A200
GREENVILLE SC
29615-3593
US

IV. Provider business mailing address

PO BOX 2507
GREENVILLE SC
29602-2507
US

V. Phone/Fax

Practice location:
  • Phone: 864-454-5632
  • Fax:
Mailing address:
  • Phone: 864-372-3064
  • Fax: 864-282-4394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number62365
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: