Provider Demographics
NPI:1053801720
Name:ANSLEY, KRISTIN MARIE (NURSE PRACTITIONER,)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARIE
Last Name:ANSLEY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER,
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:MARIE
Other - Last Name:SCARBOROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER,
Mailing Address - Street 1:300 W COLEMAN BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464
Mailing Address - Country:US
Mailing Address - Phone:843-606-2530
Mailing Address - Fax:800-564-5952
Practice Address - Street 1:300 W COLEMAN BLVD
Practice Address - Street 2:STE 101
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-606-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21563363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology