Krystal Foggie

Individual provider Active NPI Registered Nurse · Laurens, SC

NPI 1104244342 · NPPES record last updated Apr 4, 2014

Key facts

NPI
1104244342
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
208623 (SC)
Practice address
113 Hunters CT
Laurens, SC 29360-2372
Phone
(185) 578-7266
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
208623SCMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 208623 SC Yes

Addresses

Primary practice location

113 Hunters CT
Laurens, SC 29360-2372

Mailing address

1405 Chestnut Street Ext
Laurens, SC 29360-3011
Phone (855) 787-2660

Other providers in Laurens, SC

All providers in Laurens, SC · Registered Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.