=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528235942
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTIE ELIZABETH APPELGREN M.D., M.S.C.R.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2008
-----------------------------------------------------
Last Update Date | 05/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5320 KINGSWOOD DRIVE EXT
-----------------------------------------------------
City | ROCK HILL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29732-9589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-209-0829
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5320 KINGSWOOD DRIVE EXT
-----------------------------------------------------
City | ROCK HILL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29732-9589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-209-0829
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 39200000X
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------