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General NPI Number Information
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NPI Number | 1164171070
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Entity Type | Individual
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Provider Name | HALEY KENIMER HAM FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 1207 N CASHUA DR
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City | FLORENCE
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State | SC
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Zip | 29501-6937
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Country | US
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Telephone | 843-665-6172
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 FABER PLACE DR STE 300
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City | CHARLESTON
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State | SC
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Zip | 29405-8587
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Country | US
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Telephone | 737-226-6700
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Fax | 877-384-3106
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 25943
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License Number State | SC
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