=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083578462
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. KIMBERLY MARIE SINGLETON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2025
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 845 HOUSTON NORTHCUTT BLVD
-----------------------------------------------------
City | MT PLEASANT
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29464-3446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-359-2712
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1605 RIVER RD
-----------------------------------------------------
City | MC CLELLANVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29458-9544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-359-2712
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246Q00000X
-----------------------------------------------------
Taxonomy Name | Pathology Specialist/Technologist
-----------------------------------------------------
License Number | B9E4E3G5
-----------------------------------------------------
License Number State |
-----------------------------------------------------