MEDICARE: MS. ELISABETH LANDRY KRYWAY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA950	SC
2	363AM0700X	Medical Physician Assistant	001000084	NC

General Provider Information

NPI Number	:	1356390934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELISABETH LANDRY KRYWAY PA

Provider Business Mailing Address
First Line	:	7555 NORTHSIDE DR
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-4211
Country	:	US
Telephone Number	:	843-797-8162
Fax Number	:	843-797-8372

Provider Business Practice Location Address
First Line	:	7555 NORTHSIDE DR
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-4211
Country	:	US
Telephone Number	:	843-797-8162
Fax Number	:	843-797-8372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	11/14/2025

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