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General NPI Number Information
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NPI Number | 1053284661
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Entity Type | Individual
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Provider Name | KIERSTEN R WILLIMAS
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 327 BROAD ST
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City | SUMTER
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State | SC
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Zip | 29150-4152
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Country | US
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Telephone | 803-773-5227
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Fax |
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Provider Business Mailing Address
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Address Line | 130 HIDDEN BAY DR
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City | SUMTER
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State | SC
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Zip | 29154-4706
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | SC
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