Healthcare Provider Details

I. General information

NPI: 1811808223
Provider Name (Legal Business Name): KIMBERLY LEIGH ADAMS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 N MAIN ST
LANCASTER SC
29720-2188
US

IV. Provider business mailing address

977 N MAIN ST
LANCASTER SC
29720-2188
US

V. Phone/Fax

Practice location:
  • Phone: 803-745-7001
  • Fax: 803-745-7002
Mailing address:
  • Phone: 803-745-7001
  • Fax: 803-745-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number16229
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: