Healthcare Provider Details

I. General information

NPI: 1285720722
Provider Name (Legal Business Name): KRIS J. BARENDS NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL RIDGE DR
GREENVILLE SC
29605-4267
US

IV. Provider business mailing address

7 INDEPENDENCE PT SUITE 140
GREENVILLE SC
29615-4566
US

V. Phone/Fax

Practice location:
  • Phone: 864-220-7270
  • Fax:
Mailing address:
  • Phone: 864-797-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberN235
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: