Doctor Name: | KIRSTEN M HANLEY |
NPI Number: | 1215123575 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | 3000 |
Business Practice Address: | 101 Springhall Dr Goose Creek, SC - 294455336 |
Business Phone Number: | 8435723300 |
Business Fax Number: | |
Mailing Address: | 101 Springhall Dr, GOOSE CREEK |
State: | SC |
Postal Code: | 294455336 |
Phone Number: | 8435723300 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2007 |
NPI Last Update Date: | 10/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 3000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |