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General NPI Number Information
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NPI Number | 1679174650
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Entity Type | Individual
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Provider Name | KRISTIN WELBORN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 701 GROVE RD
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City | GREENVILLE
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State | SC
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Zip | 29605-4210
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Country | US
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Telephone | 864-455-5336
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Fax | 864-455-1637
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Provider Business Mailing Address
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Address Line | 701 GROVE RD
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City | GREENVILLE
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State | SC
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Zip | 29605-4210
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Country | US
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Telephone | 864-455-5336
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Fax | 864-455-1637
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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 | 1835C0205X
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Taxonomy Name | Critical Care Pharmacist
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License Number | 12682
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License Number State | SC
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